Knowledge and practice of nursing in sickle cell disease and hemoglobinopathies in primary care / Conocimiento y práctica de enfermería en el cuidado de la enfermedad de células falciformes y hemoglobinopatías en la atención primaria / Conhecimento e prática de enfermagem no atendimento à doença falciforme e hemoglobinopatias na atenção primária

ABSTRACT Objective: to investigate the level of knowledge of nurses in Basic Health Units and their engagement in monitoring patients with sickle cell disease and other hemoglobinopathies. Methods: this is a qualitative, descriptive-exploratory study, carried out with 12 nurses from basic health units in the municipality of Santa Luzia/Minas Gerais between August 2018 and February 2019. The semi-structured interview was the technique used for data collection, which was analyzed using Content Analysis. Results: the analysis of the interviews emerged in the construction of three categories: understanding of sickle cell disease, risk factors, and alterations on physical examination; nursing care at the health unit according to the recommendation of the Ministry of Health; obstacles and facilitators for the tracking and identification of patients. Discourse analysis highlighted: the outstanding presence of misconceptions regarding sickle cell disease; the absence of effective follow-up of patients in the area covered by the nurse; and the non-existence of a positive sickle cell disease patient link with primary care. Conclusion: although nursing plays a fundamental role in monitoring and assisting patients with sickle cell disease, the study revealed a significant gap between care recommendations and practice in basic health units.

RESUMEN Objetivo: investigar el nivel de conocimiento de los enfermeros de las Unidades Básicas de Salud y su participación en el seguimiento de pacientes con enfermedad de células falciformes y otras hemoglobinopatías. Método: se trata de un estudio cualitativo descriptivo-exploratorio, realizado con 12 enfermeros de unidades básicas de salud de la ciudad de Santa Luzia/Minas Gerais entre agosto de 2018 y febrero de 2019. La entrevista semiestructurada fue la técnica utilizada para la recolección de datos, que fueron analizados mediante el Análisis de Contenido. Resultados: el análisis de las entrevistas emergió en la construcción de tres categorías: comprensión sobre la enfermedad de células falciformes, factores de riesgo y alteraciones en el examen físico; atención de enfermería en la unidad de salud según recomendación del Ministerio de salud; obstáculos y facilitadores para el seguimiento e identificación de pacientes. El análisis del discurso destacó: la marcada presencia de conceptos erróneos en relación con la enfermedad de células falciformes; la falta de seguimiento efectivo de los pacientes en el área cubierta por la enfermera; y la inexistencia de un vínculo positivo entre el paciente y la enfermedad células falciformes con atención primaria. Conclusiones: si bien la enfermería tiene un papel fundamental en la conducción del seguimiento y atención de los pacientes con enfermedad de células falciformes, el estudio reveló una brecha significativa entre las recomendaciones de atención y la práctica en las unidades básicas de salud.

RESUMO Objetivos: investigar o nível de conhecimento dos enfermeiros das Unidades Básicas de Saúde e o engajamento destes no acompanhamento de pacientes com doença falciforme e outras hemoglobinopatias. Métodos: este é um estudo qualitativo descritivo-exploratório, realizado com 12 enfermeiros de unidades básicas de saúde do município de Santa Luzia/Minas Gerais entre agosto de 2018 a fevereiro de 2019. A entrevista semiestruturada foi a técnica utilizada para coleta de dados, as quais foram analisadas usando a Análise de Conteúdo. Resultados a análise das entrevistas emergiu na construção de três categorias: compreensão sobre a doença falciforme, fatores de risco e alterações ao exame físico; assistência do enfermeiro na unidade de saúde segundo a recomendação do Ministério da Saúde; dificultadores e facilitadores para o rastreamento e identificação dos pacientes. A análise do discurso destacou: a presença marcante de conceitos equivocados em relação à doença falciforme; a ausência de acompanhamento efetivo dos pacientes da área de abrangência do enfermeiro; e a não existência de vínculo entre paciente com doença falciforme positivo e a atenção básica ou uma lacuna significativa entre as recomendações de cuidado e a prática nas unidades básicas de saúde. Conclusão: embora a enfermagem desempenhe um papel fundamental no monitoramento e na assistência aos pacientes com doença falciforme, o estudo revelou uma lacuna significativa entre as recomendações de cuidados e a prática nas unidades básicas de saúde.

Percepção de enfermeiros sobre as práticas colaborativas interprofissionais na atenção básica em Palmas, TO / Nurses' perception about interprofessional collaborative practices concerning primary care in Palmas, TO

Com objetivo de evidenciar a percepção de enfermeiros(as) sobre as práticas colaborativas interprofissionais na Atenção Básica no município de Palmas (TO), foi realizado este estudo de abordagem qualitativa, conduzido em 34 Unidades Básicas de Saúde sobre onde as práticas colaborativas são vivenciadas. Os dados foram analisados pela técnica do Discurso do Sujeito Coletivo com base na Teoria da Representação Social. As práticas colaborativas relatadas foram: reuniões de equipe, grupos de trabalho, atendimento compartilhado, atividades em conjunto na comunidade, discussão de casos, planos terapêuticos integrados e rodas de conversa. Referiram como facilitadores: comunicação interprofissional; perfil da equipe; parceria, confiança e respeito; flexibilização da agenda para os encontros; e uma liderança colaborativa. Na percepção dos participantes, as práticas colaborativas favorecem maior eficácia na resolução de problemas complexos e intensificam os vínculos profissionais entre os membros da equipe. Ressaltaram que as práticas colaborativas são de grande relevância no âmbito da Atenção Primária à Saúde melhorando a ambiência, a satisfação no trabalho e a qualidade do serviço.

In order to evidence the perception of nurses about interprofessional collaborative practices in Primary Care in the city of Palmas, TO, this qualitative study was conducted in 34 Basic Health Units where collaborative practices are experienced. Data were analyzed using the Collective Subject Discourse technique, based on the Social Representation Theory. The collaborative practices reported were: team meetings, work groups, shared care, joint activities in the community, case discussions, integrated therapeutic plans and conversation circles. They mentioned interprofessional communication as facilitators; team profile; partnership, trust and respect; flexible schedule for meetings and collaborative leadership. In the participants' perception, collaborative practices favor greater effectiveness in solving complex problems and intensify professional bonds between team members. They emphasized that collaborative practices are of great relevance in the scope of Primary Health Care, improving the ambience, job satisfaction and the quality of the service.

Ginkgo biloba Extract Stimulates Adipogenesis in 3T3-L1 Preadipocytes.

Smaller adipocytes are related to the reversal of metabolic disorders, suggesting that molecules that can act in the adipogenesis pathway are of great interest. The objective of this study was to investigate the effect of Ginkgo biloba extract (GbE) in modulating the differentiation in preadipocytes. 3T3-L1 preadipocytes were differentiated for 7 days into adipocytes without (control group) and with GbE at 1.0 mg/mL. Lipid content and gene expression were analyzed on day 7 (D7) by Oil Red O staining and PCR Array Gene Expression. Western blotting analysis of the key adipogenesis markers was evaluated during the differentiation process at days 3 (D3), 5 (D5), and 7 (D7). GbE increased lipid content and raised the gene expression of the main adipogenesis markers. Key proteins of the differentiation process were modulated by GbE, since C/EBPß levels were decreased, while C/EBPα levels were increased at D7. Regarding the mature adipocytes' markers, GbE enhanced the levels of both FABP4 at D5, and perilipin at D3 and D5. In summary, the present findings showed that GbE modulated the adipogenesis pathway suggesting that the treatment could accelerate the preadipocyte maturation, stimulating the expression of mature adipocyte proteins earlier than expected.

Enjolras Vampré and the character of Les Misérables / Enjolras Vampré e o personagem de Les Misérables

ABSTRACT Enjolras Vampré (1885-1938) was one of the pioneering neurologists in Brazil whose name is a tribute to one of the characters of the book Les Misérables (1862), written by Victor Hugo (1802-1885). In this article, the authors point out evidence that the coincident names were not just a matter of homage, and even more so, the life of Dr. Enjolras had many similarities with the interesting character.

RESUMO Enjolras Vampré (1885-1938) foi um dos neurologistas pioneiros no Brasil cujo nome é uma homenagem a um dos personagens do livro Les Misérables (1862), escrito por Victor Hugo (1802-1885). Neste artigo, os autores apontam evidências de que os nomes coincidentes não são apenas uma questão de homenagem, mas ainda mais, a vida de Dr. Enjolras teve muitas outras semelhanças com o interessante personagem.

Enjolras Vampré and the character of Les Misérables.

Enjolras Vampré (1885-1938) was one of the pioneering neurologists in Brazil whose name is a tribute to one of the characters of the book Les Misérables (1862), written by Victor Hugo (1802-1885). In this article, the authors point out evidence that the coincident names were not just a matter of homage, and even more so, the life of Dr. Enjolras had many similarities with the interesting character.

Percepção de pacientes hipertensos sobre a doença e motivação para mudança de hábitos / Perception of hypertensive patients about the disease and motivation to change habits

O objetivo deste estudo foi conhecer as percepções de pacientes hipertensos sobre a doença e a influência de uma intervenção educativa na adoção de hábitos saudáveis relacionados aos "Oito Remédios Naturais". Estudo desenvolvido em abordagem qualitativa por meio de entrevistas semiestruturadas com oito participantes que vivenciarem uma intervenção educativa que aplicou oficinas sobre hábitos saudáveis relacionados aos "Oito Remédios Naturais". Para análise utilizou-se a técnica do Discurso do Sujeito Coletivo, fundamentada na Teoria da Representação Social, que permitiu a representação de 15 Ideias Centrais, entre as quais se destacam: "Antes das oficinas a qualidade de vida era ruim"; "Conscientização dos riscos da hipertensão e motivação para adotar hábitos saudáveis"; "Percepção de benefícios físicos, emocionais e espirituais após as oficinas"; "Ingestão de mais água, devido ao incentivo nas oficinas"; "Dificuldade quanto à temperança e o sono, pela complexidade em romper velhos hábitos"; "A motivação foi aprender sobre os remédios naturais" e "A confiança em Deus aumenta a motivação para se cuidar". Os participantes reconheceram os riscos da hipertensão, demonstrando compreender a influência da adoção de hábitos saudáveis no controle e prevenção de suas complicações. Reconheceram também a complexidade dos determinantes sociais implicados neste contexto.

The objective of this study was to know the perceptions of hypertensive patients about the disease and the influence of an educational intervention in the adoption of healthy habits related to the "Eight Natural Remedies." The study developed was a qualitative approach through semi-structured interviews with eight participants who experienced an educational intervention that applied workshops on healthy habits related to the "Eight Natural Remedies." For analysis, the Collective Subject Discourse technique was used, based on the Social Representation Theory, which allowed the representation of 15 Central Ideas, among which the following stand out: "Before the workshops, the quality of life was poor"; "Awareness of the risks of hypertension and motivation to adopt healthy habits"; "Perception of physical, emotional and spiritual benefits after the workshops"; "Ingestion of more water, due to the incentive in the workshops"; "Difficulty intemperance and sleep, due to the complexity of breaking old habits"; "The motivation was to learn about natural remedies" and "Trust in God increases the motivation to take care of yourself." The participants recognized the risks of hypertension, demonstrating an understanding that adopting healthy habits influences in the control and prevention of its complications. They also recognized the complexity of the social determinants involved in this context.

Percepção de portadores de diabetes sobre educação em saúde e adoção de hábitos saudáveis / Perception of people with diabetes on health education and adoption of healthy habits

Este estudo teve como objetivo conhecer a percepção de portadores de Diabetes Mellitus Tipo 2 sobre a influência da educação em saúde para a adoção de hábitos saudáveis e o controle da doença. Trata-se de um estudo qualitativo fundamentado na Teoria da Representação Social. Os depoimentos de 23 entrevistados foram analisados por meio da técnica do Discurso do Sujeito Coletivo. Emergiram das respostas quatro Ideias Centrais a respeito das orientações de profissionais quanto aos hábitos saudáveis que podem contribuir para controle da doença, e seis que versaram acerca do modo como as ações educativas podem ser mais efetivas com vistas a estimular a adoção de um estilo de vida mais saudável. Com base nas representações dos participantes, este estudo trouxe a reflexão de que a educação em saúde, como recurso para incentivar a mudança de hábitos, só se torna efetiva quando fundamentada na realidade de cada indivíduo, envolvendo diálogo, escuta qualificada e capacitação para o autocuidado.

This study aimed to know the perception of Type 2 Diabetes Mellitus patients on the influence of health education for the adoption of healthy habits and disease control. The method used was a qualitative study based on Theory of Social Representation. The testimonies of 23 interviewees were analyzed using the Collective Subject Discourse technique. Four Central Ideas emerged from the testimonies on the guidelines of professionals regarding healthy habits that can contribute to disease control, and six that dealt with how educational actions can be more effective in stimulating the adoption of a healthier lifestyle. Based on the representations of the participants, this study brought the reflection that health education, as a resource to encourage the change of habits, only becomes effective when based on the reality of each individual, involving dialogue, qualified listening and training for the self-care.

Construção de um plano de ação para inserção da espiritualidade na Atenção Primária à Saúde / Construction of an action plan to insert spirituality in Primary Health Care

Este estudo objetivou descrever o processo de construção de um plano de ação para inserção da assistência espiritual na Atenção Primária à Saúde. Trata-se de um relato de experiência que envolveu profissionais de uma regional da Estratégia Saúde da Família (ESF) do distrito do Capão Redondo, em São Paulo (SP). Utilizaram-se oficinas para promover a reflexão/ação, as quais resultaram no compartilhamento de saberes e no reconhecimento da importância da espiritualidade para a integralidade na atenção à saúde. Na estruturação do plano de ação recorreu-se ao modelo 5W2H (What, Why, Where, When, Who, How e How much), contemplando em sua operacionalização três níveis de abrangência: individual, coletivo e institucional. Os participantes reconheceram dificuldades relacionadas às condições gerais do serviço e à formação dos profissionais, mas vislumbraram possibilidades para implementação das propostas. O plano de ação construído, pautado na realidade deles, apresenta perspectivas transformadoras para a promoção da saúde integral.

This study aimed to describe the process of building an action plan on the insertion of spiritual assistance in Primary Health Care. This is an experience report that involved professionals from a regional Family Health Strategy, in the district of Capão Redondo in São Paulo (SP). Workshops were used to promote reflection/action, which resulted in the sharing of knowledge and recognition of the importance of spirituality for integrality in health care. In structuring the action plan, the 5W2H model (What, Why, Where, When, Who, How e How much) was used, contemplating in its operationalization three levels of coverage: individual, collective and institutional. The participants recognized difficulties related to the general conditions of the service and the training of professionals, but they saw possibilities for implementing the proposals. The built action plan, based on the participants' reality, presents transforming perspectives for the promotion of integral health.

Ginkgo biloba Extract (GbE) Restores Serotonin and Leptin Receptor Levels and Plays an Antioxidative Role in the Hippocampus of Ovariectomized Rats.

Since Ginkgo biloba extract (GbE) was reported to improve the hypothalamic serotonergic system of ovariectomized (OVX) rats, the present study aimed to verify the GbE effects on hippocampal oxidative stress, inflammation, and levels of the serotonin transporter (5-HTT), and both the serotonin (5-HT1A, 5-HT1B) and leptin receptors of OVX rats. Two-month-old female Wistar rats had their ovaries surgically removed (OVX) or not (SHAM). After 60 days, OVX rats were gavaged daily with GbE 500 mg kg-1 (OVX+GbE), while SHAM and OVX groups received saline 0.9% (vehicle) for 14 days. Rats were then euthanized, and hippocampi were collected. Both 5-HT1A and 5-HT1B levels were significantly reduced in OVX rats compared to SHAM rats, while 5-HT1A was higher in OVX+GbE rats in comparison to OVX rats. Similarly, LepR levels were increased in OVX+GbE rats compared to OVX rats, reaching similar levels to SHAM rats. Superoxide dismutase activity increased in OVX rats in relation to SHAM rats, which was restored to SHAM levels by GbE treatment. Additionally, GbE significantly increased the glutathione peroxidase activity in comparison to the SHAM group. No differences were observed either in catalase activity or in the levels of 5-HTT, PKCα, TLR-4, NF-κBp50, ERK, and CREB. In summary, our results show a potential effect of GbE on hippocampal pathways involved in feeding behavior, and thus, they suggest that GbE activity might improve menopausal-related hippocampal disorders, offering an alternative therapeutic tool particularly for women to whom hormone replacement therapy may be contraindicated.

Ginkgo biloba extract (GbE) attenuates obesity and anxious/depressive-like behaviours induced by ovariectomy.

While several pieces of evidence link obesity and mood disorders in menopause, the mechanisms involved are not yet fully understood. We have previously demonstrated that Ginkgo biloba extract (GbE) both attenuated diet-induced obesity of male rats and restored serotonin-induced hypophagia in ovariectomized female rats. The present study aimed at exploring whether GbE treatment ameliorates ovariectomy-related obesity and anxious/depressive-like behaviours. Wistar female rats were either ovariectomized (OVX) or sham-operated (Sham). After 2 months, either 500 mg/kg of GbE or vehicle were administered daily by gavage for 14 days. Anxious/depressive-like behaviours were assessed by the Elevated Plus Maze and the Forced Swim Tests, respectively. Ovariectomy caused high visceral adiposity, hyperleptinemia, and hypercholesterolemia, and increased the anxiety index (p = 0.048 vs. Sham + GbE) while it decreased the latency to immobility (p = 0.004 vs. Sham). GbE treatment in OVX rats improved body composition, adiponectin levels and blood lipid profile. It also reduced the anxiety index (p = 0.004) and increased the latency to immobility (p = 0.003) of OVX rats. Linear regression analysis demonstrated that leptin (p = 0.047) and total cholesterol levels (p = 0.022) were associated with anxious-like behaviours while body adiposity (p = 0.00005) was strongly associated with depressive-like behaviours. The results showed that GbE therapy was effective in attenuating the deleterious effects of ovariectomy on body composition, lipid profile, and anxious/depressive-like behaviours. Further studies are warranted to better understand the therapeutic potential of GbE in menopause.

Religion, Age, Education, Lifestyle, and Health: Structural Equation Modeling.

This study aimed to analyze the moderating effect of religion between sociodemographic variables, lifestyle, and self-referred physical and mental health. Cross-sectional study with non-randomized sample of 392 participants. The Eight Natural Remedies Questionnaire was used to assess lifestyle. Religion was found to be positive predictor between age, education and lifestyle, better physical and mental health. Being an Adventist positively influenced the lifestyle (r = 0.680; p < 0.05) and consequently physical (r = 0.222) and mental health (r = 0.220). Belonging to a religion that emphasizes a healthy lifestyle is a contributing factor toward better lifestyle, physical and mental health.

PPAR-γ agonist pioglitazone reduces microglial proliferation and NF-κB activation in the substantia nigra in the 6-hydroxydopamine model of Parkinson's disease.

BACKGROUND: Peroxisome proliferator-activated receptor γ (PPAR-γ) agonists have received much attention in research because of their neuroprotective and anti-inflammatory effects that reduce cell death and halt the progression of neurodegeneration. Thus, this study observed the pioglitazone effects on the main inflammatory markers after 6-hydroxydopamine (6-OHDA) lesion. METHODS: The effects of a 5-day administration of the PPAR-γ agonist pioglitazone (30 mg/kg) in male Wistar rats that received bilateral intranigral infusions of 6-OHDA. After surgery, the rats were evaluated in the open-field test on days 1,7,14, and 21. Immediately after the behavioral tests on day 21, the rats were euthanized, and the substantia nigra was removed to analyze the expression of nuclear factor κB (NF-κB) and IκB by western blot. To immunohistochemical, animals were intracardially perfused, with brain removal that was frozen and sectioned, being selected slices of the SNc region to detect tyrosine hydroxylase (TH) immunoreactivity, microglia activation (Iba-1) and NF-κB translocation in the nucleus. RESULTS: Pioglitazone protected rats against hypolocomotion and 6-OHDA-induced dopaminergic neurodegeneration on day 7. Decreases in the microglial activation and the NF-κB expression were observed, and the p65 activation was inhibited. CONCLUSIONS: These results suggest that pioglitazone may be a potential adjuvant for the treatment of Parkinson`s disease because of its effects on pathological markers of the progression of neurodegeneration.

PARP-1 deregulation in multiple sclerosis.

BACKGROUND: Poly (ADP-ribose) polymerase 1 (PARP-1) plays pivotal roles in immune and inflammatory responses. Accumulating evidence suggests PARP-1 as a promising target for immunomodulation in multiple sclerosis and natalizumab-associated progressive multifocal leukoencephalopathy. OBJECTIVE: This study explores expression of PARP-1 and downstream effectors in multiple sclerosis and during natalizumab treatment. METHODS: Transcriptional expressions were studied by real-time reverse transcriptase polymerase chain reaction on CD4+T/CD8+T/CD14+/B cells and peripheral blood mononuclear cells from healthy volunteers, untreated and natalizumab-treated non-progressive multifocal leukoencephalopathy and progressive multifocal leukoencephalopathy multiple sclerosis patients. RESULTS: PARP-1 expression was higher in CD4+T, CD8+T and B cells from untreated patients compared to healthy volunteers. Natalizumab treatment restored deregulated PARP-1 expression in T cells but not in B cells. Sustained upregulation of PARP-1 was associated with decreased expression of downstream PARP-1 factors such as TGFBR1/TGFBR2/BCL6 in B cells. Notably, a higher expression of PARP-1 was detected in progressive multifocal leukoencephalopathy patients. CONCLUSIONS: Given the importance of PARP-1 in inflammatory processes, its upregulation in multiple sclerosis lymphocyte populations suggests a potential role in the immune pathogenesis of multiple sclerosis. Strikingly higher PARP-1 expression in progressive multifocal leukoencephalopathy cases suggests its involvement in progressive multifocal leukoencephalopathy disease pathomechanisms. These results further support the value of PARP-1 inhibitors as a potential novel therapeutic strategy for multiple sclerosis and natalizumab-associated progressive multifocal leukoencephalopathy.

Religiosity and Physician Lifestyle from a Family Health Strategy.

This study examines the association between religiosity and physician lifestyle from a Family Health Strategy perspective. This is a cross-sectional study with 30 physicians, who completed the religiosity and lifestyle questionnaires. Among the participants, 70% (n = 21) had no "focus" on spirituality and health. The average total lifestyle score was 74.1 (SD = 8.1), but the "Physical Activity" subscale score was below average (3.4, SD = 2.37). We found eight significant correlations between religiosity and lifestyle subscales (p < 0.05). Greater religious involvement is associated with better overall and specific areas of physician lifestyle.

Integralidade na perspectiva de enfermeiros da Estratégia Saúde da Família / Integrality from the perspective of nurses in the Family Health Strategy / Integralidad en la perspectiva de enfermeros de la Estrategia Salud de la Familia

Resumo Este estudo objetivou conhecer a percepção de enfermeiros sobre a integralidade do ser humano na prática do cuidado de enfermagem no contexto da Estratégia Saúde da Família. Trata-se de pesquisa exploratória, descritiva, de abordagem qualitativa, fundamentada na Teoria da Representação Social, com amostra de conveniência composta por 29 enfermeiros de uma Regional da Estratégia Saúde da Família entrevistados entre junho e setembro de 2015. O conteúdo transcrito foi codificado e analisado com base na técnica do discurso do sujeito coletivo. Os entrevistados demonstraram clara percepção da importância da integralidade para o cuidado de enfermagem, ou seja, atender e ver o indivíduo como um todo, contemplando suas particularidades. Para que a assistência integral seja realizada no plano terapêutico são necessárias condições externas, envolvendo a atuação sincrônica da equipe multiprofissional com a macroestrutura do sistema, que se traduz em Redes de Atenção à Saúde.

Abstract The aim of the present study was to understand the perception of nurses regarding the integrality of human beings in the practice of nursing care provided through the Family Health Strategy. An exploratory and descriptive study with a qualitative approach based on the Theory of Social Representation was carried out. A convenience sample of 29 nurses from a Regional Family Health Strategy was interviewed between June and September 2015. The transcript content was coded and analyzed based on the Collective Subject Discourse technique. The respondents revealed a clear perception of the importance of integrality in nursing care and understood that attending to and viewing people based on their individual characteristics will translate this perception. In order to achieve integral care within the therapeutic plan, certain external conditions are required, involving the synchronized performance of a multidisciplinary team acting within the macrostructure of the system, which translates into Health Care Networks.

Resumen El objetivo de este estudio fue conocer la percepción de enfermeros sobre la integralidad del ser humano en la práctica del cuidado de enfermería en el contexto de la Estrategia Salud de la Familia. Se trata de una investigación exploratoria, descriptiva, con un abordaje cualitativo, fundamentada en la Teoría de la Representación Social, con una muestra de conveniencia compuesta por 29 enfermeros de una Regional de la Estrategia de Salud de la Familia, entrevistados entre junio y septiembre de 2015. El contenido transcripto fue codificado y analizado en base a la técnica del discurso del sujeto colectivo. Los entrevistados demostraron una clara percepción de la importancia de la integralidad para el cuidado de enfermería, es decir, atender y ver al individuo como un todo, contemplando sus particularidades. Para que la asistencia integral se lleve a cabo en el plano terapéutico se necesitan condiciones externas que involucran la actuación sincrónica del equipo multiprofesional con la macroestructura del sistema, que se traduce en Redes de Atención de la Salud.

Religiosidade e estilo de vida de hipertensos da Estratégia de Saúde da Família / Religiosity and lifestyle of hypertensive patients in the Family Health Strategy

Objetivo: descrever como se configura o perfil da religiosidade e estilo de vida de hipertensos. Método: estudo de campo, descritivo, de corte transversal, com abordagem quantitativa. Foram utilizados dois questionários: o “Índice de religiosidade Duke-Durel” e o “Estilo de Vida Fantástico”. A amostra de conveniência foi composta por 70 hipertensos de uma unidade da Estratégia Saúde da Família/ESF. Foi realizada a análise estatística descritiva dos dados, apresentados em uma figura e três tabelas. Resultados: população predominantemente feminina (75,7%), maioria católica (60%). A religiosidade esteve acima da média nas três dimensões. O estilo de vida “Fantástico” se apresentou “bom” (escore de 68,1), porém na dimensão “atividade física”, a média ficou no limite (4,09; dp: 2,38). Conclusão: o perfil da religiosidade e estilo de vida de hipertensos foi considerado muito bom, porém deixando a desejar na dimensão relacionada à prática de atividade física.

Religiosidade e os transtornos mentais comuns em adultos / Religiosity and common mental disorders in adults

Objetivo: analisar associação entre religiosidade e presença de transtornos mentais comuns em uma população de adultos. Método: estudo de corte transversal, descritivo e analítico, de abordagem quantitativa, com 206 participantes, utilizando os questionários Duke Durel e SRQ-20. Foram realizadas análises paramétricas e não paramétricas. Resultados: a prevalência de transtornos mentais comuns em mulheres foi maior (41,7%) que nos homens (21,4%). Não houve diferença entre médias de idade e “ter ou não” esses transtornos (p = 0,09). As mulheres apresentaram predomínio quanto ao envolvimento religioso, no entanto, ao realizar o teste do qui-quadrado, não se encontrou associação entre as dimensões da religiosidade e transtornos mentais comuns (p > 0,05). Conclusão: apesar das mulheres apresentarem maior envolvimento religioso e quase o dobro de transtornos mentais comuns, não foram encontradas associações significativas entre a religiosidade e esses transtornos.

Implantação do programa "enfermagem na comunidade de fé": relato de experiência / Implementation of the "Faith Community Nursing" Program: experience report / Implantación del programa "Enfermeras Parroquiales: relato de experiencia"

Objetivo: Descrever o processo de implantação do programa "Enfermagem na Comunidade Fé" no Brasil. Síntese dos dados: Trata-se de um relato de experiência, realizada em 2011, sobre a implantação do programa "Enfermagem na Comunidade Fé" no Brasil. Inicialmente, estabeleceu-se uma parceria entre o Centro Universitário Adventista de São Paulo e o Church Health Center em Memphis. O currículo do Church Health Center foi traduzido, revisado e implementado em quatro módulos: espiritualidade, saúde holística, profissionalismo e comunidade. Foram realizados dois cursos. O primeiro, em 2013, contou com a participação de 34 enfermeiros em período integral. O segundo, oferecido em 2016, na modalidade semipresencial, teve 20 participantes. A implantação do programa foi efetiva, uma vez que possibilitou instrumentalizar enfermeiros com uma visão holística e capacidade reflexiva para atuarem em seus locais de origem, seja em hospitais e clínicas, seja nas comunidades de fé, como multiplicadores de uma prática humanitária que valoriza todas as dimensões do ser humano. Conclusão: O programa vem se consolidando no Brasil e poderá ser uma ponte para um melhor enfrentamento das dificuldades de saúde encontradas nas comunidades.

Objective: To describe the implementation process of Faith Community Nursing (FCN) program in Brazil. Data Synthesis: This is an experience report conducted in 2011 on the implementation of the "Faith Community Nursing" program in Brazil. Initially, a partnership between The Adventist University of São Paulo and the Church Health Center in Memphis was established. The Church Health Center curriculum was translated, revised and implemented in four modules: spirituality, holistic health, professionalism and community. Two courses were conducted. The first, in 2013, counted with the participation of 34 nurses in full-time. The second, offered in 2016, in blended form, had 20 participants. The implementation of the program has been effective as it enabled the nurses to be equipped to practice care for the whole person in a reflective way in their places of origin, whether in hospitals, clinics or in faith communities, as multipliers of a humanitarian practice that values all the dimensions of the human being. Conclusion: The program has been consolidated in Brazil and can be a bridge to better cope with the health problems encountered in communities.

Objetivo: Describir el proceso de implantación del programa "Enfermeras Parroquiales" en Brasil. Síntesis de los datos: Se trata de un relato de experiencia realizado en 2011 sobre la implementación del programa "Enfermeras Parroquiales" em Brasil. En principio se estableció una sociedad entre el Centro Universitario Adventista de São Paulo y el Church Health Center en Memphis. El currículo del Church Health Center fue traducido, revisado e implementado en cuatro módulos: la espiritualidad, la salud holística, el profesionalismo y la comunidad. Se realizaron dos cursos. El primero fue en 2013 y tuvo la participación de 34 enfermeros en período integral. El segundo ha sido en 2016 en la modalidad semipresencial y tuvo 20 participantes. La implantación del programa fue efectiva ya que posibilitó la orientación de los enfermeros para una visión más holística y capacidad reflexiva para la actuación en sus sitios de origen, sean los hospitales y clínicas o en las comunidades de fe como multiplicadores de uma práctica humana que valora todas las dimensiones del ser humano. Conclusión: El programa se ha consolidado en Brasil y podrá ser un puente para un mejor afrontamiento de las dificultades de salud encontradas en las comunidades

Religiosity and lifestyle of professionals from the family health support centers / Religiosidade e estilo de vida de profissionais de um núcleo de apoio à saúde da família

Religiosity is part of the completeness of the human being and can positively influence people's lifestyle. This, in turn, is associated with chronic noncommunicable diseases in Brazil and worldwide. From this context, the objective of this study was to analyze the association between religiosity and lifestyle of health professionals from the Family Health Support Centers (NASF). It is a descriptive, cross-sectional and quantitative study. Convenience sample have been taken, in which 29 professionals answered two questionnaires: Religiosity Index "Duke-Durel" and Lifestyle "Fantastic". It was found with the studied group that the majority were female (69%, n = 20) and declared themselves Evangelicals (79%, n = 23) with an average age of 31.7 (SD = 5.71). Participants had good religious involvement (59% or more) and the lifestyle is "very good" (total score of 79.4) but are deficient in "physical activity" dimension with an average below normal (2.93, range 0-8). Almost all of them claimed to have received approach on spirituality in academic school, and had involvement in religious cults, considering the religious practice of great importance in their daily, personal and professional life. It was concluded that none of the religious variables was statistically associated with lifestyle dimensions or to their total score. However, there was an association between the variable "church attendance" and "to be or not practitioner" of religion.

A religiosidade faz parte da integralidade do ser humano e pode influenciar positivamente no estilo de vida das pessoas. Este, por sua vez, está associado às doenças crônicas não transmissíveis no Brasil e no mundo. Partindo desse contexto, o objetivo do presente estudo foi analisar a associação entre religiosidade e estilo de vida de profissionais de saúde de um Núcleo de Apoio à Saúde da Família (NASF). Pesquisa descritiva, de corte transversal e quantitativa. Amostra de conveniência que incluiu 29 profissionais. Aplicou-se dois questionários: Índice de Religiosidade Duke-Durel e Estilo de Vida Fantástico. Constatou-se, no grupo estudado, que a maioria era do sexo feminino (69%, n=20) e se declarou evangélica (79%, n=23) com idade média de 31,7 (dp=5,71). Os participantes possuíam bom envolvimento religioso (59% ou mais) e o estilo de vida "muito bom" (escore total de 79,4), porém são deficientes na dimensão "atividades físicas", com média abaixo do normal (2,93 com amplitude de 0-8). A maioria declarou ter recebido enfoque sobre espiritualidade na formação acadêmica e afirmou envolvimento em cultos religiosos, considerando a prática da religião de grande relevância em sua vida diária, pessoal e profissional. Conclui-se que, nenhuma das variáveis da religiosidade esteve estatisticamente associada às dimensões do estilo de vida Fantástico bem como ao seu escore total, no entanto houve associação entre a variável "frequência à igreja" e "ser ou não praticante" da religião.

Natalizumab-induced POU2AF1/Spi-B upregulation: A possible route for PML development.

OBJECTIVES: To assess messenger RNA (mRNA) expression of POU2AF1 and Spi-B and their potential regulatory microRNAs (miRNAs) in natalizumab-treated patients with multiple sclerosis and in therapy-associated progressive multifocal leukoencephalopathy (PML). METHODS: Expression of POU2AF1/Spi-B was analyzed by using real-time reverse transcription PCR assays on isolated B/CD8(+) T lymphocytes and peripheral blood mononuclear cells (PBMCs) from cohorts of untreated and natalizumab-treated patients with and without PML. Longitudinal expression analysis was performed on CD4(+), CD8(+) T and B cells from 14 patients who interrupted natalizumab therapy for 8 weeks. The miRNA profiling was conducted in PBMCs from 5 untreated and 5 natalizumab-treated patients using low-density arrays followed by validation with single miRNAs assays in untreated and natalizumab-treated patients. RESULTS: POU2AF1 and Spi-B mRNAs were upregulated in B and CD8(+) T cells from natalizumab-treated patients, which was validated in PBMCs from different cohorts of natalizumab-treated patients with and without PML, with a noteworthy higher expression of Spi-B in patients with PML. In contrast, downregulation of POU2AF1/Spi-B expression was measured in B and CD8(+) T cells after natalizumab discontinuation. Seventeen differentially expressed miRNAs including miR-10b, a regulator of POU2AF1 mRNA, were identified in long-term natalizumab-treated patients compared with untreated ones. CONCLUSIONS: Upregulation of POU2AF1 and Spi-B, known transactivators of the JC virus, the causative agent for PML, and its association with occurrence of PML in natalizumab-treated patients, corroborates POU2AF1/Spi-B as potential biomarkers for PML risk, which merits further evaluation.