Effect of polyphenols from Ascophyllum nodosum seaweeds on the rheology and digestion of corn starch gels and gluten-free bread features.

The main objective of this work is to study the effect of polyphenols, from the brown seaweed Ascophyllum nodosum, on the structure and digestion behaviour of gels at two corn starch concentrations (1.95 and 5.00% w/w) as well as the structure, color and texture features of crumbs from gluten-free breads. Adsorption isotherms of polyphenols on native and gelled starches were carried out and modelled by means of Langmuir and Henry models, respectively. The formation and characteristics of tested gels were rheologically monitored by means of heating ramp, time sweep at high temperature, cooling ramp and frequency sweep at 25 °C. Elastic modulus values decreased with the presence of polyphenols. Additionally, the polyphenols significantly decreased the digestion rate, measured by both chemical and rheological procedures, and the final concentration of digested starch. Finally, the presence of polyphenols in breads increased the hardness and chewiness values and decreased the cohesiveness and resilience values as well as the crumb hardening during storage.

Antioxidant and Antidiabetic Properties of Phlorotannins from Ascophyllum nodosum Seaweed Extracts.

Seaweeds have gained considerable attention in recent years due to their potential health benefits and high contents of bioactive compounds. This review focuses on the exploration of seaweed's health-promoting properties, with particular emphasis on phlorotannins, a class of bioactive compounds known for their antioxidant and antidiabetic properties. Various novel and ecofriendly extraction methods, including solid-liquid extraction, ultrasound-assisted extraction, and microwave-assisted extraction are examined for their effectiveness in isolating phlorotannins. The chemical structure and isolation of phlorotannins are discussed, along with methods for their characterization, such as spectrophotometry, nuclear magnetic resonance, Fourier transform infrared spectroscopy, and chromatography. Special attention is given to the antioxidant activity of phlorotannins. The inhibitory capacities of polyphenols, specifically phlorotannins from Ascophyllum nodosum against digestive enzymes, such as α-amylase and α-glucosidase, are explored. The results suggest that polyphenols from Ascophyllum nodosum seaweed hold significant potential as enzyme inhibitors, although the inhibitory activity may vary depending on the extraction conditions and the specific enzyme involved. In conclusion, seaweed exhibits great potential as a functional food ingredient for promoting health and preventing chronic diseases. Overall, this review aims to condense a comprehensive collection of high-yield, low-cost, and ecofriendly extraction methods for obtaining phlorotannins with remarkable antioxidant and antidiabetic capacities.

Advanced Proteomic and Bioinformatic Tools for Predictive Analysis of Allergens in Novel Foods.

In recent years, novel food is becoming an emerging trend increasingly more demanding in developed countries. Food proteins from vegetables (pulses, legumes, cereals), fungi, bacteria and insects are being researched to introduce them in meat alternatives, beverages, baked products and others. One of the most complex challenges for introducing novel foods on the market is to ensure food safety. New alimentary scenarios drive the detection of novel allergens that need to be identified and quantified with the aim of appropriate labelling. Allergenic reactions are mostly caused by proteins of great abundance in foods, most frequently of small molecular mass, glycosylated, water-soluble and with high stability to proteolysis. The most relevant plant and animal food allergens, such as lipid transfer proteins, profilins, seed storage proteins, lactoglobulins, caseins, tropomyosins and parvalbumins from fruits, vegetables, nuts, milk, eggs, shellfish and fish, have been investigated. New methods for massive screening in search of potential allergens must be developed, particularly concerning protein databases and other online tools. Moreover, several bioinformatic tools based on sequence alignment, motif identification or 3-D structure predictions should be implemented as well. Finally, targeted proteomics will become a powerful technology for the quantification of these hazardous proteins. The ultimate objective is to build an effective and resilient surveillance network with this cutting-edge technology.

Influence of Oxidation and Dialysis of Phlorotannins on Bioactivity and Composition of Ultrasound-Assisted Extracts from Ascophyllum nodosum.

The isolation and chemical characterization of phlorotannins has gained special attention in recent years due to their specific health-promoting benefits. Flow-cell ultrasound-assisted extraction (90 W/cm2 of sonication power, 2 min of retention time and 20 g solvent/g algae of liquid-solid ratio) was carried out by using double-distilled water (WE) and acetone:water mixture (AWE) as extraction solvents. The AWE showed a higher total polyphenols content (TPC), carbohydrates (CHOs) and antioxidant activities than WE. However, when the WE was purified by using Amberlite XAD16 column, the purified WE (PWE) showed similar a TPC, decreased CHOs and increased antioxidant activity compared to WE. The oxidation of the PWE extract was evaluated under natural, forced and severe oxidation condition for 120 h. Only severe oxidation conditions were able to significantly reduce TPC and antioxidant activities. PWE was dialyzed (20, 10, 3.5 and 2 kDa). The main bioactive fraction of phlorotannins was obtained from 10 to 20 kDa. CHOs were distributed in fractions below 20 kDa. MALDI-TOF analysis was performed for PWE, PD20 and PD2 extracts to analyze the degree of polymerization of phlorotannins, which ranged from 4 to 17 phloroglucinol units/molecule. Fragmentation patterns allowed the proximate identification of several phlorotannins in Ascophyllum nodosum extracts.

Unraveling the impact of viscosity and starch type on the in vitro starch digestibility of different gels.

Starch is one of the most important carbohydrates that is present in many foods. Gelatinization is an important property of starch, associated with physical changes that promote an increase in viscosity. The objective of this research was to understand how the viscosity of starch gels affects their hydrolysis and whether that effect was dependent on the type of starch. Different gels (corn, wheat, and rice) with variable or constant viscosity were analyzed using diverse methodologies to determine the changes in the pasting behavior. A rapid force analyzer, a vibration viscometer and a rheometer were used to differentiate the gels based on the starch source and concentration. At a fixed starch concentration, corn gel displayed the highest viscosity, slowing the enzymatic starch hydrolysis. The higher viscosity of those gels prepared with a fixed starch concentration significantly enhanced the slowly digestible starch (SDS) and reduced the kinetic constant (k). Nevertheless, gels with constant viscosity (550 mPa s) showed comparable hydrolysis kinetics, obtaining similar SDS, total hydrolyzed starch and k. The correlation matrix confirmed the relationship between k and gel viscosity (r = -0.82), gelatinization rate (α-slope) (r = -0.87), breakdown (r = -0.84) and elastic modulus (G' 37 °C) (r = -0.73). Therefore, these parameters could be used as predictors of the hydrolysis performance of starch gels as well as in reverse engineering for the design of healthy foods.

In vitro inhibition of starch digestive enzymes by ultrasound-assisted extracted polyphenols from Ascophyllum nodosum seaweeds.

Seaweeds are gaining importance due to their antidiabetic characteristics. This study investigated the inhibitory effects of aqueous Ascophyllum nodosum extracts, obtained by ultrasound-assisted extraction with different sonication powers (70-90 W/cm2 ) and subjected to resin purification, against α-amylase and α-glucosidase enzymes. Different inhibition methodologies were carried out, preincubating the extract either with the enzyme or the substrate. Chemical characterization, in terms of proximate analysis, antioxidant capacity (2,2-diphenyl-1-picryl-hydrazyl-hydrate [DPPH] and FRAP), and polyphenols characteristics (reversed-phase high-performance liquid chromatography [RP-HPLC] and 1 H-NMR) were carried out to explain inhibitory activities of extracts. Sonication power did not influence the proximal composition nor antiradical activity of extracts, but increasing sonication power increased inhibition capacity (>15%) against both starch digestive enzymes. The extract purification largely improved the inhibition efficiency decreasing the IC50 of α-amylase and α-glucosidase by 3.0 and 6.1 times, respectively. Seaweed extracts showed greater inhibition effect when they were preincubated with the enzyme instead of the substrate. RP-HPLC together with 1 H-NMR spectra allowed relating the presence of uronic acids-polyphenols complexes and quinones in the extracts with the different inhibitory capacities of samples. PRACTICAL APPLICATION: The study confirms that ultrasound-assisted extracts from Ascophyllum nodosum can be used to inhibit digestive enzymes. This opens the alternative to be used in foods for modulating glycemic index.

Interactions between Ascophyllum nodosum Seaweeds Polyphenols and Native and Gelled Corn Starches.

The effect of several blending procedures between Ascophyllum nodosum seaweed flour (AF) and corn starch (CS) on the interactions between polyphenols and starch was studied in this paper. These methods comprised the blending of AF with native starch (NT) with previously gelled starch gel (GL) and promoting the gelling of corn starch in the presence of AF (CGL). Different AF-CS (g/g) ratios (from 1:0.5 to 1:25) were studied. The liquid phase was chemically characterized by polyphenols (TPC) and carbohydrates content. The antioxidant activity of the liquid phase after achieving the solid-liquid equilibrium was determined by DPPH, ABTS, and FRAP methods. The solid phase was characterized by FT-IR and SEM techniques. The Halsey model successfully fitted the equilibrium TPC in liquid and polyphenols adsorbed/retained by the solid phase of tested systems. NT samples showed lower polyphenols sorption than gelled samples. The differences found between samples obtained with GL and CGL methods suggested different interactions between polyphenols and starch. Specifically, physisorption is predominant in the case of the GL method, and molecular trapping of polyphenols in the starch gel structure is relevant for the CGL method. Results allowed us to determine the enhancement of the retention of polyphenols to achieve starchy foods with high bioactivity.

Rheological Properties of Corn Starch Gels With the Addition of Hydroxypropyl Methylcellulose of Different Viscosities.

The objective of this study is to determine the effect of the addition of hydroxypropyl methylcellulose (HPMC) (from 0.5 to 2.0% w/w, starch basis) with three different viscosities (40-60, 80-120, and 2,600-5,600 mPa⋅s) to corn starch (30% w/w, total basis) gels. Average viscosimetric molecular weights (M v ) of tested HPMC were determined (from 27.2 × 103 to 82.7 × 103 g/mol). Water retention capacity of HPMC varied linearly with M v . The formation and curation of gels were monitored by rheology employing consecutive steps such as heating ramp (25-90°C), time sweep (90°C), cooling ramp (90-25°C), time sweep (25°C), and frequency sweep. Additionally, creep-recovery tests were performed. HPMC above 1.5% w/w delayed the range of gelatinization temperature of starch up to 2°C. Viscoelasticity and stiffness of corn starch gels with HPMC depend on both the amount of polymer added and M v of the HPMC. Finally, to achieve corn gels with mimetic viscoelastic properties to wheat gel (with constant total solids), HPMC with relatively low viscosity (low M v ) is necessary to be added at certain content.

Concepção das pessoas hipertensas e diabéticas acerca dos impactos da síndrome metabólica na sua saúde / Conception of hypertense and diabetic people about the impacts of metabolic syndrome on their health / Concepción de personas hipertensas y diabéticas sobre los impactos del síndrome metabólico en su salud

RESUMO Objetivo Conhecer a concepção dos usuários de um programa de hipertensão e diabetes acerca da síndrome metabólica. Método Trata-se de um estudo exploratório-descritivo com abordagem qualitativa realizado na cidade de Jequié, Bahia. Os participantes da pesquisa foram usuários do programa hipertensão e diabetes de um Centro de Saúde. Esse estudo foi aprovado pelo Comitê de Ética em Pesquisa da Universidade Estadual do Sudoeste da Bahia (Parecer N°. 013/2011). Resultados Partir da análise de conteúdo emergiram três categorias: concepção da síndrome metabólica; fatores psicossociais e tratamento, e seis subcategorias: a vida em risco; medo; indiferença; diminuição da capacidade para realização das atividades da vida diária; dificuldade em se adaptar à dieta e adesão ao tratamento medicamentoso. Conclusão Percebeu-se que a doença tem um impacto negativo na vida dos usuários, pois entendem a doença como um fator que expõe suas vidas a risco e que pode reduzir ou limitar suas capacidades para a realização das tarefas diárias.

ABSTRACT Objective To know the conception of users of a hypertension and diabetes program about metabolic syndrome. Method This is an exploratory-descriptive study with a qualitative approach conducted in the city of Jequié, Bahia. The study participants were users of the hypertension and diabetes program of a health center. This study was approved by the Research Ethics Committee of the State University of Southwest Bahia (Opinion N°. 013/2011). Results From content analysis three categories emerged: conception of the metabolic syndrome; psychosocial factors and treatment, and six subcategories: life-threatening; fear; indifference; decreased ability to perform activities of daily living; difficulty adapting to diet, and adherence to drug treatment. Conclusions It was perceived that the disease has a negative impact on users' lives as they understand the disease as a risk factor that can reduce or limit their ability to perform daily tasks.

RESUMEN Objetivo Conocer la concepción de los usuarios de un programa de hipertensión y diabetes sobre el síndrome metabólico. Método Estudio exploratorio descriptivo con enfoque cualitativo realizado en la ciudad de Jequié, Bahía. Los participantes del estudio eran usuarios del programa de hipertensión y diabetes de un Centro de Salud. Este estudio fue aprobado por el Comité de Ética en Investigación de la Universidad Estatal del Sudoeste de Bahía (Opinión N°. 013/2011). Resultados Del análisis de contenido surgieron tres categorías: concepción del síndrome metabólico; factores psicosociales y tratamiento, y seis subcategorías: vida en riesgo; miedo, indiferencia, disminución de la capacidad para realizar actividades de la vida diaria; dificultad para adaptarse a la dieta, y adherencia al tratamiento farmacológico. Conclusión Se percibió que la enfermedad tiene un impacto negativo en la vida de los usuarios, ya que entienden la enfermedad como un factor de riesgo que puede reducir o limitar su capacidad para realizar las tareas diarias.

Estimation of viscosity and hydrolysis kinetics of corn starch gels based on microstructural features using a simplified model.

Viscosity is an important rheological property, which may have impact on the glycemic response of starchy foods. However, the relationship between starch gels viscosity on its hydrolysis has not been elucidated. The aim of this work was to assess the effect of gels viscosity on the microstructure, and the kinetics of enzymatic hydrolysis of starch. Corn starch gels were prepared from starch:water ratios varying from 1:4 to 1:16. A structural model was proposed that correlated (R-square = 0.98) the porous structure (cavity sizes, thickness walls) of gels and its viscosity. Kinetics constants of hydrolysis decreased with increasing starch content and consequently with gel viscosity. Relationships of viscosity with the microstructural features of gels suggested that enzyme diffusion into the gel was hindered, with the subsequent impact on the hydrolysis kinetics. Therefore, starch digestibility could be governed by starch gels viscosity, which also affected their microstructure.

Impact of drying on the sodium alginate obtained after polyphenols ultrasound-assisted extraction from Ascophyllum nodosum seaweeds.

Ultrasound-assisted extraction (UAE) of polyphenols from the brown seaweeds Ascophyllum nodosum leaves a solid phase where alginates can be extracted. This study characterizes alginates extracted after the UAE process, with and without an intermediate drying stage at different temperatures (50 and 90 °C) producing sequentially two bioactive compounds from a unique raw material. FT-IR and 1H NMR analyses showed the high purity of alginates with features in the range of commercial alginates. Drying at high temperature decreased average block length and viscosity average molecular weight (Mv) of alginate from 428 to 133 kg/mol. Steady-shear curves (shear-thinning behaviour) and viscoelasticity (liquid like character) features depended clearly on Mv. Solutions of alginates with high Mv were more viscous and the elastic character was more relevant. Cox-Merz rule was only accomplished within the semi-dilute regimes of alginate concentration. Tested process conditions allow the production of alginates with different properties.

Glycosyl squaramides, a new class of supramolecular gelators.

Glycosyl squaramides were synthesised and evaluated as low molecular weight gelators. Amphiphilic glycosyl squaramides 5 and 6, with a C-16 aliphatic chain, formed thermoreversible gels in polar organic solvents and 1 : 1 ethanol/water mixtures with high efficiency. Rheological analysis showed these gels achieve their structural stability 120 h after gelation and were robust, making them particularly suitable for biomedical applications. The interactions between solvent and gelator strongly influence SAFiN (Self-Assembled Fibrillar Network) formation, critical gelation concentration (CGC) and subsequent gel structure, as evidenced by SEM imaging of xerogels. Spectroscopic studies indicate that H-bonding is involved in the self-assembly of the glycosyl squaramides in organic solvents, while hydrophobic interactions are the major driving force for gel formation in the presence of water. The compounds described herein are the first reported examples of carbohydrate-squaramide conjugates capable of forming supramolecular gels.

Atendimento em Saúde à Pessoa com Deficiência e a Formação Inicial do Profissional de Saúde: o que Há rntre Nós?1 / Health Care for the Person with Disability and the Initial Training of the Health Professional: what Is Between Us?1

RESUMO: O processo de formação do profissional de saúde tem se modificado na busca de educar profissionais com uma visão integral e que proponham mudanças na sociedade. Dentro desse contexto, a saúde da pessoa com deficiência merece destaque, tendo em vista que essas pessoas têm mais barreiras de acessos aos serviços prestados por esses profissionais, tais como dificuldade de comunicação, empatia do profissional, barreiras arquitetônicas, instrumentais, entre outras. Logo, este estudo objetiva analisar como duas universidades públicas discutem a saúde da pessoa com deficiência dentro do currículo do profissional de saúde. Para isso, analisaram-se projetos pedagógicos de oito cursos de Saúde. Concluiu-se que os projetos analisados não garantem uma formação integral no que tange à atenção à saúde da pessoa com deficiência.

ABSTRACT: The process of training the health professional has changed in the search to educate professionals with an integral vision and who propose changes in the society. Within this context, the health of people with disabilities deserves to be highlighted, given that these people have more access barriers to the services provided by these professionals, such as communication difficulties, professional empathy, architectural, instrumental barriers, among others. Therefore, this study aims to analyze how two public universities discuss the health of the person with disability within the curriculum of the health professional. For this, we analyzed pedagogical projects of eight health courses. We concluded that the projects analyzed do not guarantee an integral training regarding the health care of the person with disability.

Determination of thermal transitions of gluten-free chestnut flour doughs enriched with brown seaweed powders and antioxidant properties of baked cookies.

A protocol for determining the characteristic temperatures of thermomechanical transitions on gluten-free flour doughs is proposed. This protocol is based on the mathematical analysis of experimental curve of storage modulus (G') vs temperature obtained by means of Dynamic Mechanical Thermal Analysis (DMTA) technique. Doughs at constant consistency of chestnut flour with different levels (3, 6 and 9% flour basis, f.b.) of brown seaweed (Bifurcaria bifurcata, Fucus vesiculosus and Ascophyllum nodosum) powders addition, 2% f.b. of guar gum and 1.8% f.b. of salt with different water absorption were used to test the proposed protocol. The ranges of temperatures corresponding to starch gelatinization (59-97 °C), amylopectin crystallites melting (82-101 °C), reversible dissociation of lipid-amylose complexes (107-128 °C) and amylose melting (133-171 °C) showed a strong dependence with water absorption of samples. Doughs with the same water absorption submitted to starch gelatinization during mixing were also analysed to corroborate the protocol suitability. Total polyphenols content and radical scavenging activity of extracts from chestnut flour-seaweed powder blends and seaweed-enriched chestnut cookies baked at 180 °C were determined. Extraction assisted with ultrasounds was carried out employing acetone-water (70:30 v/v) solution as solvent during 4 min with a liquid/solid ratio of 30 w/w. Seaweed powder addition had a positive effect on antioxidant properties of doughs before baking. However, the seaweed powder addition effect on baked products (cookies) is not clear due to antioxidant activity is overlapped by Maillard's products generated during baking.

Repercussões da prevalencia da síndrome metabólica em adultos e idosos no contexto da atenção primária / Repercussions of the prevalence of metabolic syndrome on adults and elderly people in the context of primary health care / Repercusiones de la prevalencia del sindrome metabólico en adultos y ancianos en el contexto de la atención primaria a la salud

RESUMO Objetivo Analisar a prevalência de Síndrome Metabólica entre os usuários do programa hipertensão e diabetes de um Centro de Saúde da cidade de Jequié, Bahia, Brasil. Métodos Trata-se de um estudo descritivo de corte transversal, realizado na cidade de Jequié Bahia. Os participantes da pesquisa foram usuários do programa HIPERDIA do Centro de Saúde inserida na atenção primária. Resultados A prevalência de Síndrome Metabólica nesses usuários foi de 43%. Quanto ao gênero, a prevalência foi de 35% entre homens e 47% em mulheres, considerando que em 23% dos prontuários não havia dados suficientes para a classificação. Conclusão Evidenciou-se que a síndrome metabólica atinge proporcionalmente mais as mulheres do que os homens, ao passo que em relação à idade foi verificado maior prevalência da doença em indivíduos maiores de 60 anos.(AU)

ABSTRACT Objective To identify the prevalence of metabolic syndrome in users of the hypertension and diabetes mellitus program at a Health Center in Jequié City, Bahia, Brazil. Materials and methods This is a descriptive cross-sectional study. The sample consisted of 100 patients enrolled in HIPERDIA. This study was approved by the Research Ethics Committee of the State University of Southwest of Bahia (Minutes no. 013/2011). Results The prevalence of metabolic syndrome in these users was 43%. Regarding sex, the prevalence was 35% among men and 47% among women, considering that in 23% of the medical records there were insufficient data for classification. Conclusions It was evidenced that the metabolic syndrome reaches proportionately more women than men, whereas, in relation to age, a higher prevalence of the disease was verified in individuals older than 60 years.(AU)

RESUMEN Objetivo Analizar la prevalencia de síndrome metabólico entre los usuarios del programa hipertensión y diabetes de un Centro de Salud de la ciudad de Jequié, Bahia, Brasil. Método Se trata de un estudio descriptivo de corte transversal. La muestra fue constituida por 100 pacientes registrados en HIPERDIA. Este estudio fue aprobado por el Comité de Ética en Investigación de la Universidad Estadual del Sudoeste de Bahía (Dictamen n ° 013/2011). Resultados La prevalencia de síndrome metabólico en estos usuarios fue del 43%. En cuanto al género, la prevalen-cia fue del 35% entre hombres y el 47% en mujeres, considerando que en el 23% de los prontuarios no había datos suficientes para la clasificación. Conclusión Se evidenció que el síndrome metabólico alcanza proporcionalmente más a las mujeres que los hombres, mientras que en relación a la edad se verificó mayor prevalencia de la enfermedad en individuos mayores de 60 años.(AU)

[Repercussions of the prevalence of metabolic syndrome on adults and elderly people in the context of primary health care]. / Repercussões da prevalencia da síndrome metabólica em adultos e idosos no contexto da atenção primária.

OBJECTIVE: To identify the prevalence of metabolic syndrome in users of the hypertension and diabetes mellitus program at a Health Center in Jequié City, Bahia, Brazil. MATERIALS AND METHODS: This is a descriptive cross-sectional study. The sample consisted of 100 patients enrolled in HIPERDIA. This study was approved by the Research Ethics Committee of the State University of Southwest of Bahia (Minutes no. 013/2011). RESULTS: The prevalence of metabolic syndrome in these users was 43%. Regarding sex, the prevalence was 35% among men and 47% among women, considering that in 23% of the medical records there were insufficient data for classification. CONCLUSIONS: It was evidenced that the metabolic syndrome reaches proportionately more women than men, whereas, in relation to age, a higher prevalence of the disease was verified in individuals older than 60 years.

Structural features and water sorption isotherms of carrageenans: A prediction model for hybrid carrageenans.

EXPERIMENTAL: water adsorption and desorption isotherms of kappa/iota-hybrid carrageenan (KIC) extracted from Mastocarpus stellatus red seaweed as well as commercial kappa-carrageenan (KC) and iota-carrageenan (IC) were obtained at several temperatures (5, 25, 45, 65°C). Spectroscopic and X-ray diffraction techniques allowed identifying the fundamental composition of above biopolymers. Crystallinity values (%) followed the order IC (25.4±0.6)> KIC (9.3±0.4)> KC (4.8±0.2), which nicely matched with the hygroscopic properties of the tested biopolymers (KC > KIC > IC) at each temperature. Sulphate content and sulphation degree of KIC were also intermediate. The experimental sorption data were successfully fitted using the two-parameter Caurie model, selected following a statistical analysis. A prediction model to estimate the KIC water sorption isotherms based on its individual disaccharides units content (%mol) (kappa- (73±4) and iota- (27±4)) and including the temperature effect was successfully developed.

Internação e mortalidade hospitalar de idosos por transtornos mentais e comportamentais no Brasil, 2008-2014 / Internación y mortalidad hospitalaria de personas mayores con trastornos mentales y del comportamiento en Brasil, 2008-2014 / Hospitalization and hospital mortality of elderly people with mental and behavioral disorders in Brazil, 2008-2014

Objetivo: analisar a evolução das internações e da mortalidade hospitalar de idosos por transtornos mentais e comportamentais no Brasil, no período 2008-2014. Métodos: estudo ecológico de séries temporais, com dados do Sistema de Informações Hospitalares do Sistema Único de Saúde (SIH/SUS) analisados mediante regressão de Prais-Winsten. Resultados: registraram-se 139.941 internações e 2.962 óbitos no período; o coeficiente de internação hospitalar por transtornos mentais e comportamentais reduziu-se no Brasil, de 122,3 para 84,2 por 100 mil habitantes (-0,14%; IC95% -0,25;-0,03), e em suas grandes regiões - exceto o Sul, que apresentou tendência estacionária (0,08%; IC95% -0,11;0,27) ; os coeficientes de mortalidade hospitalar no país, em 2008 e 2014, foram, respectivamente, de 1,73 e 2,38 por 100 mil hab.; demência foi o principal diagnóstico nas internações que registraram óbitos (32,3%). Conclusão: apesar da redução do coeficiente de internação por transtornos mentais e comportamentais no período estudado, o coeficiente de mortalidade hospitalar aumentou.

Objetivo: describir la evolución de las internaciones y mortalidad de personas mayores con trastornos mentales y del comportamiento en Brasil, entre 2008 y 2014. Métodos: estudio observacional de series temporales con datos recogidos del Sistema de Información Hospitalaria (SIH/SUS), analizados mediante regresión de Prais-Winsten. Resultados: durante el período de estudio, se registraron 139.941 hospitalizaciones y 2.962 muertes, el coeficiente de hospitalización por trastornos mentales y del comportamiento disminuyeron en Brasil (122,3 por 100 a la miles de 84,2 habitantes (-0,14% - IC95% -0,25;-0,03) y sus regiones, con excepción el Sur, el cual tuvo una tendencia estacionaria (0,08% - IC95%: -0,11;0,27); los coeficientes de mortalidad hospitalaria en Brasil en 2008 y 2014 fueron, respectivamente 1,73 y 2,38 por cada 100 mil habitantes; la demencia fue el principal diagnóstico en las internaciones que registraron muertes (32,3%). Conclusión: a pesar de la reducción en el coeficiente de hospitalización por trastornos mentales y del comportamiento durante el período de estudio, el coeficiente de mortalidad hospitalaria aumentó.

Objective: to analyze the evolution of hospitalizations and hospital mortality of elderly people with mental and behavioral disorders in Brazil, from 2008 to 2014. Methods: this is a time series ecological study, with data from the Hospital Information System of the Brazilian National Health System (SIH/SUS), and analyzed through Prais-Winsten regression. Results: during the studied period, 139,941 hospitalizations and 2,962 deaths were recorded; the hospitalization coefficient for mental and behavioral disorders decreased in Brazil, from 122.3 to 84.2 per 100 thousand inhabitants (-0.14%; 95%CI -0.25;-0.03), and its macroregions, except the South, which presented stationary trend (0.08%; 95%CI -0.11;0.27); the hospital mortality coefficients in Brazil, in 2008 and 2014, were, respectively, 1.73 and 2.38 per 100 thousand inhabitants; dementia was the main diagnosis in hospitalizations that registered deaths (32.3%). Conclusion: despite the reduction in hospitalization coefficient for mental and behavioral disorders during the studied period, the hospital mortality coefficient has increased.

Hospitalization and hospital mortality of elderly people with mental and behavioral disorders in Brazil, 2008-2014. / Internação e mortalidade hospitalar de idosos por transtornos mentais e comportamentais no Brasil, 2008-2014.

OBJECTIVE: to analyze the evolution of hospitalizations and hospital mortality of elderly people with mental and behavioral disorders in Brazil, from 2008 to 2014. METHODS: this is a time series ecological study, with data from the Hospital Information System of the Brazilian National Health System (SIH/SUS), and analyzed through Prais-Winsten regression. RESULTS: during the studied period, 139,941 hospitalizations and 2,962 deaths were recorded; the hospitalization coefficient for mental and behavioral disorders decreased in Brazil, from 122.3 to 84.2 per 100 thousand inhabitants (-0.14%; 95%CI -0.25;-0.03), and its macroregions, except the South, which presented stationary trend (0.08%; 95%CI -0.11;0.27); the hospital mortality coefficients in Brazil, in 2008 and 2014, were, respectively, 1.73 and 2.38 per 100 thousand inhabitants; dementia was the main diagnosis in hospitalizations that registered deaths (32.3%). CONCLUSION: despite the reduction in hospitalization coefficient for mental and behavioral disorders during the studied period, the hospital mortality coefficient has increased.

Reflexão bioética acerca da homossexualidade no Brasil e o direito a ser diferente / Bioethical reflection about homosexuality in Brazil and the right to be different / Reflexión bioética acerca de la homosexualidad en Brasil y el derecho a ser diferente

Objetivo: refletir sobre a homossexualidade no Brasil e questões bioéticas que permeiam os direitos civis dos homossexuais. Método: estudo crítico-reflexivo, descritivo e analítico, de abordagem qualitativa, realizada por meio do método dedutivo e conduzida a partir de revisão da literatura. Resultados: a sociedade muitas vezes usa os princípios éticos e religiosos arcaicos para justificar o preconceito, a não aceitação e legalização dos direitos civis das pessoas por ser gay. Conclusão: é necessário refletir sobre o assunto e incentivar mais discussão sobre o tema, considerando se estes indivíduos como seres humanos em sua essência devem gozar de suas condições humanas e da vida em sociedade.

Objective: to reflect about homosexuality in Brazil and bioethical issues that permeate the civil rights of homosexuals. Method: this is a critical-reflective study, descriptive and analytical, which adopts a qualitative approach, accomplished through the deductive method and conducted through literature review. Results: the society often uses archaic ethical-religious principles to justify the prejudice, non-acceptance and legalization of civil rights of individuals for being homosexual. Conclusion: it is necessary to reflect about it and encourage more thorough discussions on the theme, considering these people as human beings in essence and that should enjoy of their human conditions and life in the society.(AU)

Objetivo: reflexionar sobre homosexualidad en Brasil y las cuestiones bioéticas que permean los derechos civiles de los homosexuales. Método: se trata de un estudio crítico-reflexivo, descriptivo y analítico, que adopta un enfoque cualitativo, realizado a través del método deductivo y conducido a través de revisión bibliográfica. Resultados: la sociedad con frecuencia utiliza principios ético-religiosos arcaicos para justificar los prejuicios, la no aceptación y legalización de los derechos civiles de las personas por ser homosexuales. Conclusión: es necesario reflexionar a este respecto y fomentar más discusiones sobre la temática, considerando estos individuos como seres humanos en esencia y que deben disfrutar de sus condiciones humanas y de la vida en la sociedad.(AU)