Behaviour Hallmarks in Alzheimer's Disease 5xFAD Mouse Model.

The 5xFAD transgenic mouse model widely used in Alzheimer's disease (AD) research recapitulates many AD-related phenotypes with a relatively early onset and aggressive age-dependent progression. Besides developing amyloid peptide deposits alongside neuroinflammation by the age of 2 months, as well as exhibiting neuronal decline by the age of 4 months that intensifies by the age of 9 months, these mice manifest a broad spectrum of behavioural impairments. In this review, we present the extensive repertoire of behavioural dysfunctions in 5xFAD mice, organised into four categories: motor skills, sensory function, learning and memory abilities, and neuropsychiatric-like symptoms. The motor problems, associated with agility and reflex movements, as well as balance and coordination, and skeletal muscle function, typically arise by the time mice reach 9 months of age. The sensory function (such as taste, smell, hearing, and vision) starts to deteriorate when amyloid peptide buildups and neuroinflammation spread into related anatomical structures. The cognitive functions, encompassing learning and memory abilities, such as visual recognition, associative, spatial working, reference learning, and memory show signs of decline from 4 to 6 months of age. Concerning neuropsychiatric-like symptoms, comprising apathy, anxiety and depression, and the willingness for exploratory behaviour, it is believed that motivational changes emerge by approximately 6 months of age. Unfortunately, numerous studies from different laboratories are often contradictory on the conclusions drawn and the identification of onset age, making preclinical studies in rodent models not easily translatable to humans. This variability is likely due to a range of factors associated with animals themselves, housing and husbandry conditions, and experimental settings. In the forthcoming studies, greater clarity in experimental details when conducting behavioural testing in 5xFAD transgenic mice could minimise the inconsistencies and could ensure the reliability and the reproducibility of the results.

PoCOsteo: generic novel platform for bone turnover marker measurement & monitoring.

Despite the increasing efforts in improving bone health assessments, current diagnostics suffer from critical shortcomings. The present article therefore describes a multiplex label-free immunosensor designed and validated for the assessment of two bone turnover markers (BTMs), namely beta isomerized C-terminal telopeptide of type I collagen (CTx) and Procollagen I Intact N-Terminal (PINP), the combination of which is needed to illustrate an accurate overview of bone health. The immunosensor was then tested outside and inside of a microsystem, with the aim of becoming compatible with a point of care system fabricated for automated assessment of these biomarkers later-on at patient side. Custom-made monoclonal antibodies were specifically designed for this purpose in order to guarantee the selectivity of the immunosensor. In the final platform, a finger prick blood sample is introduced into the microfluidic manifolds without any need for sample preparation step, making the tool suitable for near patient and outside of the central laboratory applications. The platform was exploited in 30 real blood samples with the results validated using electrochemiluminescence immunoassay. The results revealed the platform was capable of measuring the target analyte with high sensitivity and beyond the recommended clinical reference range for each biomarker (CTx: 104-1028 ng L-1 and PINP: 16-96 µg L-1, correspondingly). They also showed the platform to have a limit of detection of 15 (ng L-1) and 0.66 (µg L-1), a limit of quantification of 49 (ng L-1) and 2.21 (µg L-1), and an inter- and intra-assay coefficient of variance of 5.39-6.97% and 6.81-5.37%, for CTx and PINP respectively, which is comparable with the gold standard. The main advantage of the platform over the state-of-the art was the capability of providing the results for two markers recommended for assessing bone health within 15 minutes and without the need for skilled personnel or costly infrastructure.

Impact of high Spirulina diet, extruded or supplemented with enzymes, on blood cells, systemic metabolites, and hepatic lipid and mineral profiles of broiler chickens.

The impact of 15% dietary inclusion of Spirulina (Arthrospira platensis) in broiler chickens was explored, focusing on blood cellular components, systemic metabolites and hepatic lipid and mineral composition. From days 14 to 35 of age, 120 broiler chickens were divided and allocated into four dietary treatments: a standard corn and soybean meal-based diet (control), a 15% Spirulina diet, a 15% extruded Spirulina diet, and a 15% Spirulina diet super-dosed with an enzyme blend (0.20% porcine pancreatin plus 0.01% lysozyme). The haematological analysis revealed no significant deviations (p > 0.05) in blood cell counts across treatments, suggesting that high Spirulina inclusion maintains haematological balance. The systemic metabolic assessment indicated an enhanced antioxidant capacity in birds on Spirulina diets (p < 0.001), pointing toward a potential reduction in oxidative stress. However, the study noted a detrimental impact on growth performance metrics, such as final body weight and feed conversion ratio (both p < 0.001), in the Spirulina-fed treatments, with the super-dosed enzyme blend supplementation failing to alleviate these effects but with extrusion mitigating them. Regarding hepatic composition, birds on extruded Spirulina and enzyme-supplemented diets showed a notable increase in n-3 fatty acids (EPA, DPA, DHA) (p < 0.001), leading to an improved n-6/n-3 PUFA ratio (p < 0.001). Despite this positive shift, a reduction in total hepatic lipids (p = 0.003) was observed without a significant change in cholesterol levels. Our findings underscore the need for further exploration into the optimal inclusion levels, processing methods and potential enzymatic enhancements of Spirulina in broiler diets. Ultimately, this research aims to strike a balance between promoting health benefits and maintaining optimal growth performance in poultry nutrition.

Insights on the Use of Transgenic Mice Models in Alzheimer's Disease Research.

Alzheimer's disease (AD), the leading cause of dementia, presents a significant global health challenge with no known cure to date. Central to our understanding of AD pathogenesis is the ß-amyloid cascade hypothesis, which underlies drug research and discovery efforts. Despite extensive studies, no animal models of AD have completely validated this hypothesis. Effective AD models are essential for accurately replicating key pathological features of the disease, notably the formation of ß-amyloid plaques and neurofibrillary tangles. These pathological markers are primarily driven by mutations in the amyloid precursor protein (APP) and presenilin 1 (PS1) genes in familial AD (FAD) and by tau protein mutations for the tangle pathology. Transgenic mice models have been instrumental in AD research, heavily relying on the overexpression of mutated APP genes to simulate disease conditions. However, these models do not entirely replicate the human condition of AD. This review aims to provide a comprehensive evaluation of the historical and ongoing research efforts in AD, particularly through the use of transgenic mice models. It is focused on the benefits gathered from these transgenic mice models in understanding ß-amyloid toxicity and the broader biological underpinnings of AD. Additionally, the review critically assesses the application of these models in the preclinical testing of new therapeutic interventions, highlighting the gap between animal models and human clinical realities. This analysis underscores the need for refinement in AD research methodologies to bridge this gap and enhance the translational value of preclinical studies.

Brazilian Society of Otology task force - Vestibular Schwannoma - evaluation and treatment

Abstract Objective: To review the literature on the diagnosis and treatment of vestibular schwannoma. Methods: Task force members were educated on knowledge synthesis methods, including electronic database search, review and selection of relevant citations, and critical appraisal of selected studies. Articles written in English or Portuguese on vestibular schwannoma were eligible for inclusion. The American College of Physicians' guideline grading system and the American Thyroid Association's guideline criteria were used for critical appraisal of evidence and recommendations for therapeutic interventions. Results: The topics were divided into 2 parts: (1) Diagnosis - audiologic, electrophysiologic tests, and imaging; (2) Treatment - wait and scan protocols, surgery, radiosurgery/radiotherapy, and systemic therapy. Conclusions: Decision making in VS treatment has become more challenging. MRI can diagnose increasingly smaller tumors, which has disastrous consequences for the patients and their families. It is important to develop an individualized approach for each case, which highly depends on the experience of each surgical team.

Sexually-transmitted monkeypox: report of two cases

Abstract Monkeypox is an emerging infection that has spread to all continents since May 2022. It is caused by the zoonotic monkeypox virus, consisting of double-stranded DNA, belonging to the Orthopoxvirus genus of the Poxviridae family, which has high transmissibility, especially by contact with the skin, favoring its sexual transmission. This case report describes a same-sex male couple, both aged 28 years old, without comorbidities. In the index case, perioral and penile lesions started ten days before the consultation, with rapid progression and a high fever that started eight days after the appearance of the lesions. In the second case, the perioral lesions started three days after the partner; however, he remained afebrile. Both were isolated, treated with symptomatic measures, and, after ulceration, the lesions completely regressed in 14 days. Dermatologists should be aware of manifestations of monkeypox, which may include vesiculopustular lesions in areas of sexual contact, as well as oligosymptomatic cases or cases with few skin lesions.

What do Cochrane systematic reviews say about therapeutic tinnitus interventions? / O que revisões sistemáticas Cochrane dizem sobre terapêutica para zumbido?

INTRODUCTION: Tinnitus is a sound perception not related to stimulation. It can significantly impair the quality of life and its treatment is considered one significant challenge of Medicine. OBJECTIVE: To evaluate systematic reviews developed by Cochrane regarding therapeutic interventions for subjective tinnitus. METHODS: It is an overview of Cochrane systematic reviews. We searched systematic reviews on Cochrane Library. The MeSH term "tinnitus" was used for searches. Inclusion criteria involved therapeutic interventions for patients with subjective tinnitus. RESULTS: The search strategy recovered 577 citations with 14 Cochrane systematic reviews. 13 were included because they were focusing on primary tinnitus interventions. One review had no scope of analysis for tinnitus and it was excluded. 7,998 tinnitus patients were evaluated. CONCLUSION: There is a lack of evidence of the effectiveness of any intervention for tinnitus treatment, considering the studies performed so far and compiled in Cochrane systematic reviews.

INTRODUÇÃO: O zumbido é a sensação do som sem que haja estimulação ambiental. Pode prejudicar significativamente a qualidade de vida e seu tratamento é considerado um grande desafio da Medicina. OBJETIVO: Avaliar as revisões sistemáticas desenvolvidas pela Cochrane, no que concerne às intervenções terapêuticas para o zumbido subjetivo. MÉTODOS: Trata-se de overview de revisões sistemáticas Cochrane. Procedeu-se à busca por revisões sistemáticas na Cochrane Library. Foi utilizado o termo DeCS "zumbido". Os critérios de inclusão envolveram intervenções terapêuticas para pacientes com zumbido subjetivo. RESULTADOS: A estratégia de busca recuperou 577 citações e, destas, 14 revisões sistemáticas Cochrane, sendo que 13 enfocavam intervenções primárias para zumbido, sendo estas incluídas neste estudo. Uma revisão não tinha escopo de análise para zumbido e foi excluída. Foram avaliados 7.998 portadores de zumbido. CONCLUSÃO: Há carência de evidência de efetividade de qualquer intervenção, medicamentosa ou não, para tratamento do zumbido, considerando os estudos realizados até o momento e compilados em revisões sistemáticas Cochrane.

Experiences of families of adolescents with gender incongruence in the light of the Calgary Models for Families / Experiencias de familias adolescentes con incongruencia de género a la luz de los Modelos Calgary para familias / Experiências de famílias de adolescentes com incongruência de gênero à luz dos Modelos Calgary para famílias

ABSTRACT Objective: to know the experiences of family members of adolescents with gender incongruence. Method: this is a qualitative case study, supported by the Calgary Family Assessment and Intervention Models theoretical-methodological framework. Data collection took place through semi-structured interviews, participant observation in family groups and document analysis, with eight family members. Data analysis was performed following the precepts of content analysis. Results: with family assessment, two categories emerged: "Challenges in the face of gender transition", which highlighted the problems related to the expectations created at birth, new names, pronouns and gender fluidity and the fear of prejudice, and "Supporting aspects in the face of the possibility of gender transition", which revealed family support as a strong point. Conclusion: knowing the experiences allowed us to understand the challenges that family members face when facing physical and emotional aspects of their children's gender transition. It was noticed that the act of seeking help and offering support is important for a healthy transition. The findings provided a better understanding of family issues and provided suggestions on how nursing can develop care for this population.

RESUMEN Objetivo: conocer las vivencias de familiares de adolescentes con incongruencia de género. Método: estudio de caso cualitativo, sustentado en el referencial teórico-metodológico de los Modelos de Evaluación e Intervención Familiar de Calgary. La recolección de datos se llevó a cabo a través de entrevistas semiestructuradas, observación participante en grupos familiares y análisis de documentos, con ocho familiares. El análisis de los datos se realizó siguiendo los preceptos del análisis de contenido. Resultados: con el diagnóstico familiar surgieron dos categorías: "Desafíos frente a la transición de género", que destacó los problemas relacionados con las expectativas creadas al nacer, nuevos nombres, pronombres y fluidez de género y miedo al prejuicio, y "Aspectos de apoyo ante la posibilidad de transición de género", que revelaron el apoyo familiar como punto fuerte. Conclusión: conocer las experiencias permitió comprender los desafíos que enfrentan los miembros de la familia al enfrentar aspectos físicos y emocionales de la transición de género de sus hijos. Se notó que el acto de buscar ayuda y ofrecer apoyo es importante para una transición saludable. Los hallazgos proporcionaron una mejor comprensión de los problemas familiares y proporcionaron sugerencias sobre cómo la enfermería puede desarrollar el cuidado de esta población.

RESUMO Objetivo: conhecer as experiências de familiares de adolescentes com incongruência de gênero. Método: estudo de caso qualitativo, apoiado pelo referencial teórico-metodológico dos Modelos Calgary de Avaliação e Intervenção Familiar. A coleta dos dados ocorreu por meio de entrevistas semiestruturadas, observação participante em grupos de familiares e análise documental, com oito familiares. A análise dos dados foi realizada seguindo os preceitos da análise de conteúdo. Resultados: com a avaliação familiar, emergiram duas categorias: "Desafios em face à transição de gênero", que evidenciou os problemas relacionados às expectativas criadas ao nascimento, novos nomes, pronomes e fluidez de gênero e o medo do preconceito, e "Aspectos apoiadores diante da possibilidade de transição de gênero", que revelou o apoio familiar como ponto forte. Conclusão: conhecer as experiências permitiu compreender os desafios que os familiares enfrentam ao se deparar com aspectos físicos e emocionais da transição de gênero de seus filhos. Percebeu-se que o ato de procurar ajuda e de oferecer apoio é importante para uma transição saudável. Os achados proporcionaram melhor compreensão das questões familiares e forneceram sugestões de como a enfermagem pode elaborar o cuidado a essa população.

Proteomic research and diagnosis in bladder cancer: state of the art review

ABSTRACT Purpose: Proteomic biomarkers have been emerging as alternative methods to the gold standard procedures of cystoscopy and urine cytology in the diagnosis and surveillance of bladder cancer (BC). This review aims to update the state of the art of proteomics research and diagnosis in BC. Materials and Methods: We reviewed the current literature related to BC research on urinary, tissue, blood and cell line proteomics, using the Pubmed database. Findings: Two urinary protein biomarkers are FDA-approved (NMP22® and BTA® tests), only if performed along with cystoscopy for surveillance after initial diagnosis, but not in the primary diagnostic setting due to high false-positive rates in case of infections, stones and hematuria. There are a great number of non-FDA approved proteins being studied, with good preliminary results; panels of proteins seem valuable tools to be refined in ongoing trials. Blood proteins are a bigger challenge, because of the complexity of the serum protein profile and the scarcity of blood proteomic studies in BC. Previous studies with the BC tissue proteome do not correlate well with the urinary proteome, likely due to the tumor heterogeneity. Cell line proteomic research helps in the understanding of basic mechanisms that drive BC development and progression; the main difficulty is culturing low-grade tumors in vitro, which represents the majority of BC tumors in clinical practice. Conclusion: Protein biomarkers have promising value in the diagnosis, surveillance and prognostic of BC. Urine is the most appropriate body fluid for biomarker research in BC due to its easiness of sampling, stability and enrichment of shed and secreted tumor-specific proteins. Panels of biomarkers may exhibit higher sensitivity than single proteins in the diagnosis of BC at larger populations due to clinical and tumor heterogeneity. Prospective clinical trials are warranted to validate the relevance of proteomic data in the clinical management of BC.

Implicações do bullying na saúde mental de adolescentes obesos: revisão integrativa / Implications of bullying in the mental health of obese adolescents: integrative review

A violência é um problema de saúde pública crescente, que traz sérias consequências individuais e sociais. Nesse contexto, destaca-se a prática de bullying relacionado à obesidade. Não é incomum indivíduos considerados obesos sofrerem maior exclusão social e apresentarem quadros de ansiedade, privação e problemas de comportamento alimentar que se agravam com a prática do bullying. O objetivo deste artigo é aprofundar a discussão a respeito das implicações do bullying na saúde mental de adolescentes obesos. Trata-se de um estudo de revisão integrativa realizada nas bases eletrônicas: Biblioteca Virtual em Saúde (BVS), United States National Library of Medicine (PubMed); e Scientifc Electronic Library Online (SciELO). Do total de estudos incluídos na revisão final (n = 05), 02 foram realizados no Brasil, 01 no Reino Unido, 01 nos Estados Unidos e 01 na Noruega. Foi possível observar a existência de sentimentos negativos vivenciados por adolescentes obesos, vítimas de bullying, tais como ansiedade, tristeza, angústia e sentimento de exclusão social. Tais achados evidenciam uma certa urgência para o desenvolvimento de ações permanentes de enfrentamento ao bullying e promoção do convívio saudável.

Violence is a growing public health problem that brings serious individual and social consequences. In this context, it stands out the practice of bullying related to obesity. It is not uncommon that obese individuals suffer more from social exclusion and present anxiety issues, eating deprivation and behavior problems that aggravate the bullying. The objective of this article is to deepen the discussion about the implications of bullying on the mental health of obese adolescents. It is a study of integrative review performed in electronic databases: Virtual Health Library (VHL), United States National Library of Medicine (PubMed); and Scientifc Electronic Library Online (SciELO). The total number of studies included in the review end (n = 05), 02 were conducted in Brazil, 01 in the United Kingdom, 01 in the United States and 01 in Norway. It was possible to observe the existence of negative feelings experienced by obese adolescents, victims of bullying, such as anxiety, sadness, anguish and feelings of social exclusion. Such findings show a certain urgency for the development of permanent actions to fight against bullying and promote a healthy living.

Social Support on Facebook, Self Esteem and Self Transcendence within The Five Factor Model of Personality

Abstract As human relations change the way they develop social support, social networks have become crucial to human interaction and overall subjective welfare. Critical social networks, such as Facebook, have developed hundreds upon millions of virtual communities and influence the way individuals interact with one another. This literature review aims to explore the following positive and negative implications of the use of Facebook. a) Facebook plays a negative role in the users' welfare and self-esteem. b) Facebook is also used as a communication tool to positively impact ongoing social support or increase the users' feeling of self-worth. c) Facebook can influence one's ability to detach from the external definitions of self and dissolve the rigid link between oneself and others, enabling transcendence, leading to an increased sense of self-worth. d) Lastly, the five-factor model of personality can be used to explore online and offline behavior and its impact on Self Esteem. Results of these final dimensions indicated that both (i) Neuroticism and (ii) Extraversion were positively associated with Facebook behavioral addiction, whereas (iii) Openness to Experience, (iv) Agreeableness, and (v) Conscientiousness were negatively associated with a Facebook behavioral addiction. These positive associations suggest thematic relevance and are noteworthy for future academic research. This review serves as a foundation for assessing current findings and offering recommendations for future exploration, encouraging the academic community to conduct further research as the new era of technology unfolds.

Satisfação dos usuários com os cuidados de enfermagem no ambiente hospitalar / Satisfação dos usuários com os cuidados de enfermagem no ambiente hospitalar User satisfaction with nursing care in the hospital environment / Satisfacción del usuario con atención de enfermería en el entorno del hospital

Objetivo: analisar o nível de satisfação dos usuários com os cuidados de enfermagem no ambiente hospitalar. Métodos: estudo transversal, analítico, quantitativo, realizado com 101 pacientes de um hospital do Centro-Sul do Piauí, no período de março de 2016 a janeiro de 2017. Utilizou-se a "Escala de satisfação do cliente" da Classificação dos Resultados de Enfermagem, com análise dos resultados a partir do Software Statistic Package for Social Sciences. Resultados: os pacientes se mostraram satisfeitos com os cuidados de enfermagem (58,4%). As variáveis que apresentaram associação estatisticamente significante com a satisfação foram "raça/cor" (p=0,028) e "situação conjugal" (p=0,030), além dos indicadores "alimentar-se" (p=0,018) e "higiene" (p=0,035) da escala de autocuidado. Conclusão: a satisfação dos pacientes permite a identificação de potencialidades e deficiências fornecendo contribuições para a reorganização das atividades assistenciais, gerenciais e de ensino

Objective: to analyze the level of user satisfaction with nursing care in the hospital environment. Method: cross-sectional, analytical, quantitative study, carried out with 101 patients from a hospital in the Center-South of Piauí, from March 2016 to January 2017. The "Customer Satisfaction Scale" of the Results Classification of Nursing, with analysis of the results using the Statistic Package for Social Sciences Software. Results: patients were satisfied with nursing care (58.4%). The variables that showed a statistically significant association with satisfaction were "race / color" (p = 0.028) and "marital status" (p = 0.030), in addition to the indicators "eating" (p = 0.018) and "hygiene" (p = 0.035) of the self-care scale. Conclusion: patient satisfaction allows the identification of potential and deficiencies, providing contributions for the reorganization of care, management and teaching activities

Objetivo: analizar el nivel de satisfacción del usuario con la atención de enfermería en el entorno hospitalario. Método: estudio transversal, analítico, cuantitativo, realizado con 101 pacientes de un hospital del Centro-Sur de Piauí, de marzo de 2016 a enero de 2017. La "Escala de satisfacción del cliente" de la Clasificación de resultados de Enfermería, con análisis de resultados utilizando el Paquete Estadístico para Software de Ciencias Sociales. Resultados: los pacientes quedaron satisfechos con los cuidados de enfermería (58.4%). Las variables que mostraron una asociación estadísticamente significativa con la satisfacción fueron "raza / color" (p = 0.028) y "estado civil" (p = 0.030), además de los indicadores "comer" (p = 0.018) e "higiene" (p = 0.035) de la escala de autocuidado. Conclusión: la satisfacción del paciente permite la identificación de potenciales y deficiencias, aportando contribuciones para la reorganización de las actividades de atención, gestión y enseñanza

Ultrasound findings of pubertal development in girls with cystic fibrosis and their association with clinical outcomes and Tanner staging

ABSTRACT Objective: Patients with cystic fibrosis (CF) have a high incidence of pubertal and growth delay. In girls with CF, pubertal delay has an important psychological impact. Still, only a few studies have explored the occurrence of pubertal delay in girls with CF. The aims of this study were to compare the pubertal development of girls with CF compared with healthy controls regarding Tanner staging and pelvic ultrasound and, in girls with CF, correlate the findings with those of spirometry, body mass index, Shwachman-Kulczycki score (SKS), and genotyping. Subjects and methods: This was a cross-sectional, case-control study including 35 girls with CF aged 6-17 years and following up at the Pediatric Pulmonology Outpatient Clinic of a tertiary hospital. These patients were compared with 59 healthy controls who had undergone pelvic ultrasound as part of another study conducted by the same group. Girls with CF were consecutively enrolled in the study during their annual routine check-up visit. Data collected in the CF group included spirometry and anthropometric results, SKS values, bone age, occurrence of current cystic fibrosis-related diabetes (CFRD) and Pseudomonas aeruginosa colonization, history of meconium ileus, genotype, ultrasound parameters, and Tanner stage. Results: Pelvic ultrasound findings and Tanner stage reflected less pubertal development in girls with CF compared with healthy controls. Pubertal stage in patients with CF who presented CFRD (3.17 ± 1.16), had chronic colonization by Pseudomonas aeruginosa (3.10 ± 1.10), or were homozygous for the F508del mutation (1.91 ± 1.30) was more delayed than in controls (3.41 ± 1.41). Tanner stage correlated with age at menarche, bone age, and anthropometric and ultrasound data. Conclusions: Girls with CF presented a delay in pubertal development evaluated by Tanner stage and ultrasound parameters, which was more evident in the presence of comorbidities.

Merkel cell carcinoma metastatic to the testis: report of a rare diagnosis and review of the literature

Merkel cell carcinoma is an aggressive malignancy that frequently recurs/disseminates, but metastases to the genitourinary tract are rare. Only eight cases of Merkel cell carcinoma metastatic to the testis are reported. We describe the ninth case of this event and provide a review of the literature. A 58-year-old man diagnosed with Merkel cell carcinoma of the wrist, presented, 37 months later, a recurrence in the form of a testicular metastasis. The tumor consisted of a monotonous proliferation of small, blue, round cells, with immunoexpression of neuroendocrine markers and the typical dot-like paranuclear immunostaining for cytokeratin 20, in the absence of immunostaining for cytokeratin 7. The patient is alive with no evidence of disease. Clinicians should be aware of the possibility of metastatic dissemination to the testis since genital examination/imaging is not part of routine follow-up for these patients, but timely orchiectomy may be curative.

Embracement of the person with mental illness at an emergency hospital service: a qualitative research / Acogimiento de la persona em sufrimento mental en servicio de urgencia en hospital: investigación cualitativa / Acolhimento da pessoa em sofrimento mental em serviço hospitalar de emergência: pesquisa qualitativa

ABSTRACT Objectives: to understand actions of nurses who care for people person with mental illness at a Referenced Emergency Unit in a university hospital. Methods: a qualitative research based on Alfred Schütz's social phenomenology. Data collection was performed between December 2015 and January 2016 through phenomenological interviews with 13 nurses from an Emergency Unit. Results: nurses embrace according to their previous experiences. They easily identify biological complaints and, when they recognize psychiatric signs and symptoms, refer them to the psychiatrist. They raise doubts about what to do, so they expect to be qualified for such action, believing that a protocol could help as well as they need more time. Final considerations: the understanding of the lived type of nurse who embraces people with mental distress made possible in this study need recognition for research and interventions that focus on biological, psychic and social dimension articulation at embracement.

RESUMEN Objetivos: comprender las acciones de las enfermeras que reciben a la persona con enfermedad mental en una Unidad de Emergencia recomendada en un hospital universitario. Métodos: investigación cualitativa, basada en la fenomenología social de Alfred Schütz. La recolección de datos se realizó entre diciembre de 2015 y enero de 2016, a través de entrevistas fenomenológicas con 13 enfermeras de una Unidad de Emergencia. Resultados: las enfermeras aceptan de acuerdo con sus experiencias anteriores, identifican fácilmente las quejas biológicas y, cuando reconocen los signos y síntomas psiquiátricos, los remiten al psiquiatra. Tienen preguntas sobre qué hacer, por lo que esperan estar calificados para tal acción, creen que un protocolo podría ayudar y necesitar más tiempo. Consideraciones finales: la comprensión del tipo vivido de la enfermera que recibe a la persona en sufrimiento mental hizo posible en este estudio el reconocimiento de la necesidad de investigación e intervenciones que se centren en la articulación de la dimensión biológica, psíquica y social en lo acogimiento.

RESUMO Objetivos: compreender a ação do enfermeiro que realiza acolhimento da pessoa em sofrimento mental em Unidade de Emergência Referenciada em um hospital universitário. Métodos: pesquisa qualitativa, fundamentada na fenomenologia social de Alfred Schütz. A coleta de dados foi realizada entre dezembro de 2015 e janeiro de 2016, por meio de entrevistas fenomenológicas com 13 enfermeiros de uma Unidade de Emergência. Resultados: os enfermeiros acolhem de acordo com suas experiências prévias, identificam facilmente queixas biológicas e, quando reconhecem sinais e sintomas psiquiátricos, encaminham ao psiquiatra. Apresentam dúvidas sobre o que fazer, portanto, esperam ser qualificados para tal ação, acreditam que um protocolo poderia ajudar, bem como necessitam de mais tempo. Considerações finais: a compreensão do tipo vivido do enfermeiro que acolhe a pessoa em sofrimento mental possibilitou, neste estudo, o reconhecimento da necessidade de pesquisas e intervenções que foquem na articulação da dimensão biológica, psíquica e social na ação do acolhimento.

Sentimentos do enfermeiro ao acolher paciente psiquiátrico agitado e agressivo / Nurses' feelings when accommodating an agitated and aggressive psychiatric patient

Objetivo: compreender como o enfermeiro se sente ao acolher o paciente psiquiátrico agitado e agressivo em uma unidade de emergência. Método: trata-se de estudo qualitativo, descritivo, com 13 enfermeiros que atuam diuturnamente na sala de acolhimento de uma Unidade de Emergência, a partir de entrevistas gravadas, transcritas e analisadas pelo referencial teórico metodológico da Fenomenologia Social. Resultados: relataram-se, pelos enfermeiros, desconforto e preocupação com sua segurança e integridade física ao acolher o paciente psiquiátrico agitado e agressivo, entendendo essas apresentações como obstáculos, assim como a sua falta de preparo pessoal. Destacou-se que o local é desfavorável para o acolhimento, com excesso de estímulos ambientais. Caracterizam-se, assim, as suas expectativas pela necessidade de ambiente reservado e calmo. Conclusão: mostrou-se, pela compreensão dos sentimentos dos enfermeiros, que não se sentem confortáveis nessa ação, o que impacta negativamente o modo como atuam. Tornou-se possível entender que técnicas de manejo e utilização do relacionamento interpessoal terapêutico podem ser estratégias para facilitar a abordagem desses pacientes em unidades de emergência.(AU)

Objective: to understand how the nurse feels when welcoming the agitated and aggressive psychiatric patient in an emergency unit. Method: this is a qualitative, descriptive study, with 13 nurses who work daily in the reception room of an Emergency Unit, based on recorded interviews, transcribed and analyzed by the theoretical methodological framework of Social Phenomenology. Results: the nurses reported discomfort and concern about their safety and physical integrity when welcoming the agitated and aggressive psychiatric patient, understanding these presentations as obstacles, as well as their lack of personal preparation. It was highlighted that the place is unfavorable for welcoming, with an excess of environmental stimuli. Thus, their expectations are characterized by the need for a reserved and calm environment. Conclusion: it was shown, by understanding the nurses' feelings, that they do not feel comfortable in this action, which negatively impacts the way they act. It became possible to understand that techniques for handling and using therapeutic interpersonal relationships can be strategies to facilitate the approach of these patients in emergency units.(AU)

Objetivo: comprender cómo se siente el enfermero cuando recibe al paciente psiquiátrico agitado y agresivo en una unidad de emergencia. Método: es un estudio cualitativo, descriptivo, con 13 enfermeros que trabajan diariamente en la sala de recepción de una Unidad de Emergencia, a partir de entrevistas grabadas, transcritas y analizadas por el marco metodológico teórico de la Fenomenología Social. Resultados: los enfermeros informaron incomodidad y preocupación por su seguridad e integridad física al dar la bienvenida al paciente psiquiátrico agitado y agresivo, entendiendo estas presentaciones como obstáculos, así como su falta de preparación personal. Se destacó que el lugar es desfavorable para acoger, con un exceso de estímulos ambientales. Por lo tanto, sus expectativas se caracterizan por la necesidad de un ambiente reservado y tranquilo. Conclusión: se demostró, al comprender los sentimientos de los enfermeros, que no se sienten cómodos en esta acción, lo que afecta negativamente su forma de actuar. Se ha hecho posible comprender que las técnicas para manejar y usar las relaciones terapéuticas interpersonales pueden ser estrategias para facilitar el abordaje de estos pacientes en unidades de emergencia.(AU)

Instrumento para a avaliação familiar da criança com incongruência de gênero / Tool for family assessment of the child with gender incongruity

Objetivo: apresentar a experiência do desenvolvimento de um instrumento de avaliação para sistematizar os cuidados de enfermagem da família da criança com incongruência de gênero. Método: trata-se de um estudo descritivo, tipo relato de experiência, sobre a construção de um instrumento para sistematizar a assistência de enfermagem à família da criança atendida em um ambulatório de gênero e sexualidades na infância e na adolescência de um hospital geral universitário. Desenvolveu-se a construção com base nas etapas do Processo de Enfermagem pelos Modelos Calgary de Avaliação e Intervenção Familiar. Conclusão: concluiu-se que o uso de um instrumento de avaliação permite, ao enfermeiro, obter uma macroavaliação dos pontos fortes e problemas da família, apoiando a tomada de decisão e fornecendo subsídios para o estabelecimento de problemas, pontos fortes e intervenções de enfermagem que respaldam a avaliação do cuidado integral da família assistida nessa clínica.(AU)

Objective: to report the experience of building up an evaluation tool to systematize the nursing care of the child's family with gender incongruity. Method: this is a descriptive study, case report type, on the building up of a tool to systematize nursing care to the family of the child attended in an outpatient clinic for gender and sexualities in childhood and adolescence of a general university hospital. Building up was developed based on the stages of the Nursing Process using the Calgary Models of Family Assessment and Intervention. Conclusion: it was concluded that the use of an assessment tool allows nurses to obtain a macro-assessment of the family's strengths and problems, supporting decision making and providing support for the establishment of nursing problems, strengths and interventions that support the assessment of comprehensive care of the family assisted in this clinic.(AU)

Objetivo: presentar la experiencia del desarrollo de un instrumento de evaluación para sistematizar la atención de enfermería de la familia del niño con incongruencia de género. Método: se trata de un estudio descriptivo, tipo de informe de experiencia, sobre la construcción de un instrumento para sistematizar la atención de enfermería a la familia del niño atendido en una consulta externa de género y sexualidad en la infancia y adolescencia de un hospital universitario general. La construcción se desarrolló basada a las etapas del Proceso de Enfermería utilizando los Modelos de Evaluación e Intervención Familiar de Calgary. Conclusión: se concluyó que el uso de una herramienta de evaluación permite a las enfermeras obtener una macroevaluación de las fortalezas y problemas de la familia, apoyando la toma de decisiones y brindando apoyo para el establecimiento de problemas, fortalezas e intervenciones de enfermería que apoyan la evaluación de la atención integral de la familia asistida en esta clínica.(AU)

Embracement of the person with mental illness at an emergency hospital service: a qualitative research / Acogimiento de la persona em sufrimento mental en servicio de urgencia en hospital: investigación cualitativa / Acolhimento da pessoa em sofrimento mental em serviço hospitalar de emergência: pesquisa qualitativa

ABSTRACT Objectives: to understand actions of nurses who care for people person with mental illness at a Referenced Emergency Unit in a university hospital. Methods: a qualitative research based on Alfred Schütz's social phenomenology. Data collection was performed between December 2015 and January 2016 through phenomenological interviews with 13 nurses from an Emergency Unit. Results: nurses embrace according to their previous experiences. They easily identify biological complaints and, when they recognize psychiatric signs and symptoms, refer them to the psychiatrist. They raise doubts about what to do, so they expect to be qualified for such action, believing that a protocol could help as well as they need more time. Final considerations: the understanding of the lived type of nurse who embraces people with mental distress made possible in this study need recognition for research and interventions that focus on biological, psychic and social dimension articulation at embracement.

RESUMEN Objetivos: comprender las acciones de las enfermeras que reciben a la persona con enfermedad mental en una Unidad de Emergencia recomendada en un hospital universitario. Métodos: investigación cualitativa, basada en la fenomenología social de Alfred Schütz. La recolección de datos se realizó entre diciembre de 2015 y enero de 2016, a través de entrevistas fenomenológicas con 13 enfermeras de una Unidad de Emergencia. Resultados: las enfermeras aceptan de acuerdo con sus experiencias anteriores, identifican fácilmente las quejas biológicas y, cuando reconocen los signos y síntomas psiquiátricos, los remiten al psiquiatra. Tienen preguntas sobre qué hacer, por lo que esperan estar calificados para tal acción, creen que un protocolo podría ayudar y necesitar más tiempo. Consideraciones finales: la comprensión del tipo vivido de la enfermera que recibe a la persona en sufrimiento mental hizo posible en este estudio el reconocimiento de la necesidad de investigación e intervenciones que se centren en la articulación de la dimensión biológica, psíquica y social en lo acogimiento.

RESUMO Objetivos: compreender a ação do enfermeiro que realiza acolhimento da pessoa em sofrimento mental em Unidade de Emergência Referenciada em um hospital universitário. Métodos: pesquisa qualitativa, fundamentada na fenomenologia social de Alfred Schütz. A coleta de dados foi realizada entre dezembro de 2015 e janeiro de 2016, por meio de entrevistas fenomenológicas com 13 enfermeiros de uma Unidade de Emergência. Resultados: os enfermeiros acolhem de acordo com suas experiências prévias, identificam facilmente queixas biológicas e, quando reconhecem sinais e sintomas psiquiátricos, encaminham ao psiquiatra. Apresentam dúvidas sobre o que fazer, portanto, esperam ser qualificados para tal ação, acreditam que um protocolo poderia ajudar, bem como necessitam de mais tempo. Considerações finais: a compreensão do tipo vivido do enfermeiro que acolhe a pessoa em sofrimento mental possibilitou, neste estudo, o reconhecimento da necessidade de pesquisas e intervenções que foquem na articulação da dimensão biológica, psíquica e social na ação do acolhimento.

Validade e confiabilidade da versão brasileira da Johns Hopkins Fall Risk Assessment Tool para avaliação do risco de quedas / Validity and reliability of the Brazilian version of the Johns Hopkins Fall Risk Assessment Tool to assess the risk of falls

RESUMO: Objetivo: Avaliar a validade e a confiabilidade da escala Johns Hopkins Fall Risk Assessment Tool (JH-FRAT) para avaliação do risco de quedas em pacientes hospitalizados. Método: Estudo retroativo com 297 pacientes de um hospital privado de São Paulo usando dados de 2014. A validade foi avaliada por meio da acurácia (sensibilidade, especificidade, valores preditivos positivo - VPP e negativo - VPN), da validade de critério, verificando-se as associações entre a classificação do risco pelas escalas JH-FRAT e Morse, e da análise discriminante (comparação dos pacientes com e sem quedas em relação aos itens da escala e verificação de situações prévias de risco em relação ao dano ocorrido). Foram utilizados os testes de associação χ2. A confiabilidade foi avaliada por meio da reprodutibilidade teste-reteste interobservadores, usando as estatísticas Kappa ponderado quadrático e prevalence-adjusted and bias-adjusted Kappa (PABAK). Resultados: A sensibilidade foi de 97,0%, a especificidade, 14,6%, o VPP, 36,2%, e o VPN, 90,6%. A análise de critério mostrou associação (p < 0,0001) entre as avaliações pelas duas escalas. Cinco dos oito itens da escala e a classificação geral mostraram capacidade de discriminação do risco (p < 0,050). A reprodutibilidade interobservadores variou entre itens (PABAK de 0,25 a 1,00) e foi substancial na classificação do risco global (PABAK = 0,71). Conclusão: A JH-FRAT apresentou validade e confiabilidade esperadas para um instrumento de triagem do risco de quedas, podendo contribuir na aplicação de estratégias para a gestão de quedas em hospitais.

ABSTRACT: Objective: To evaluate the validity and reliability of the Johns Hopkins Fall Risk Assessment Tool (JH-FRAT), which assesses the risk of falls in hospitalized inpatients. Method: Study with 297 patients at a hospital in São Paulo, using retrospective data form 2014. Validity was assessed by accuracy (sensitivity, specificity, positive predictive value - PPV and negative predictive value - NPV) and discriminant analysis (comparison of patients with and without falls in relation to the scale items and comparison of previous risk situations in relation to the injury). The χ2 test and Fisher's exact test were used. Reliability was assessed by reproducibility between methods and interobserver test-retest comparison in a subsample of 60 patients. We used the Kappa, quadratic weighted Kappa and PABAK statistics. Results: Sensitivity was 97.0%, specificity was 6%, PPV was 36.2% and NPV was 90.6%. Five of the eight items of the scale and the overall classification showed risk discrimination capability (p < 0.050). The risk of previous situations did not discriminate the injury resulting from the falls (p = 0.557). Reproducibility between methods was substantial (PABAK = 0.71). The interobserver reproducibility ranged between items (PABAK 0.25 to 1.00) and was substantial to the overall risk classification (PABAK = 0.71). Conclusion: JH-FRAT showed validity and reliability expected of a screening tool for risk of falls, and it can contribute to the implementation of fall management strategies in hospitals.

A systematic review of cross-cultural adaptation and validation of borg's rating of perceived exertion scale / Revisão sistemática da adaptação transcultural e validação da escala de percepção de esforço de borg

ABSTRACT The aim of this systematic review was to analyze the cross-cultural adaptation and validation processes of Borg's Rating of Perceived Exertion Scale (6-20) and its instructions during exercise in adults and the elderly. The study was conducted using databases that include the areas of health, sports and psychology (Pubmed, ScienceDirect, Bireme (BVS), PsycINFO, SportDiscus and Scopus), and descriptors in the English and Portuguese languages were standardized for all databases ("exercise" / "exercicio", "validity" / "validade", "borg scale" / "escala de borg"; "perceived exertion" / "percepção de esforço" and "validation" / "validação"). Among the 1,488 items found, 14 articles were selected for analysis. The main findings were that cross-cultural adaptation (Cantonese and Japanese) was reported in only four articles. The lowest-scored criteria for methodological quality were related to the concept of perceived exertion, and the instructions for use and familiarization with Borg's scale. The results indicate that the majority of the studies did not apply the cross-cultural adaptation process and additionally, that concurrent validity was the only validation method reported. Therefore, it is necessary to carry out the cross-cultural adaptation of Borg's Scale (6-20), mainly in the Portuguese language, in addition to other types of validation in order to ensure more accurate results.

RESUMO O objetivo dessa revisão sistemática foi analisar os processos de adaptação transcultural e validação da Escala de Percepção Subjetiva de Esforço de Borg (6-20) e de suas instruções durante o exercício em adultos e idosos. A busca foi realizada nas bases de dados da área da saúde, esporte e psicologia (Pubmed, ScienceDirect, Bireme (BVS), PsycINFO, SportDiscus e Scopus) e os descritores em inglês e português foram padronizados para todas as bases de dados ("exercise"/"exercício"; "validity"/"validade"; "borg scale"/"escala de borg"; "perceived exertion"/"percepção de esforço"; e "validation"/"validação"). Entre os 1488 artigos encontrados, foram selecionados 14 artigos para análise. Os principais resultados encontrados foram que a adaptação transcultural (Cantonês e Japonês) foi reportada em apenas quatro artigos. Os critérios mais baixos de qualidade metodológica foram aqueles relacionados a definição de percepção de esforço, a instrução e familiarização com a Escala. Os resultados indicam que a maioria dos estudos não realizou o processo de adaptação transcultural e além disso, só a validade concorrente foi utilizada como método de validação. Portanto, é necessário realizar adaptação transcultural da Escala de Borg (6-20) principalmente na língua portuguesa, além dos diferentes tipos de validação para se obter resultados mais precisos.