Empowering Cancer Patients with Self-Care and Pain Management Skills: A Quasi-Experimental Study.

BACKGROUND: Cancer patients experience distress as a result of their health condition, which, in turn, contributes to the progression of the disease. Moreover, their daily activities, well-being, and health status are significantly impacted by pain and other symptoms. In this context, empowering these patients with self-care and pain management skills can greatly contribute to effective symptom control. AIM: To develop and implement an educational approach focused on empowering family caregivers and patients with advanced cancer in effectively managing pain at home. METHOD: An educational program, PECP/C-Pain Management, was developed to empower family caregivers and cancer patients to manage pain at home. A quasi-experimental study involving 52 participants with advanced cancer was conducted to test the program. Participants' skills, behaviors, and knowledge related to self-care and pain management were assessed before and after the intervention using an appropriate instrument, the Pain Management Knowledge and Behavior Scale. RESULTS: Pain was reported as the primary symptom, and following the educational program, participants were able to monitor pain and other symptoms and effectively self-manage their treatment. CONCLUSIONS: The findings suggest that the PECP/C-Pain Management intervention was effective in improving participants' knowledge and skills in managing pain, leading to better symptom control. In addition, the Pain Management Knowledge and Behavior Scale is a reliable tool for measuring the outcomes of this intervention.

Genome-wide association and functional genomic analyses for various hoof health traits in North American Holstein cattle.

Hoof diseases are a major welfare and economic issue in the global dairy cattle production industry, which can be minimized through improved management and breeding practices. Optimal genetic improvement of hoof health could benefit from a deep understanding of the genetic background and biological underpinning of indicators of hoof health. Therefore, the primary objectives of this study were to perform genome-wide association studies, using imputed high-density genetic markers data from North American Holstein cattle, for 8 hoof-related traits: digital dermatitis, sole ulcer, sole hemorrhage, white line lesion, heel horn erosion, interdigital dermatitis, interdigital hyperplasia, and toe ulcer, and a hoof health index. De-regressed estimated breeding values from 25,580 Holstein animals were used as pseudo-phenotypes for the association analyses. The genomic quality control, genotype phasing, and genotype imputation were performed using the PLINK (version 1.9), Eagle (version 2.4.1), and Minimac4 software, respectively. The functional genomic analyses were performed using the GALLO R package and the DAVID platform. We identified 22, 34, 14, 22, 28, 33, 24, 43, and 15 significant markers for digital dermatitis, heel horn erosion, interdigital dermatitis, interdigital hyperplasia, sole hemorrhage, sole ulcer, toe ulcer, white line lesion disease, and the hoof health index, respectively. The significant markers were located across all autosomes, except BTA10, BTA12, BTA20, BTA26, BTA27, and BTA28. Moreover, the genomic regions identified overlap with various previously reported quantitative trait loci for exterior, health, meat and carcass, milk, production, and reproduction traits. The enrichment analyses identified 44 significant gene ontology terms. These enriched genomic regions harbor various candidate genes previously associated with bone development, metabolism, and infectious and immunological diseases. These findings indicate that hoof health traits are highly polygenic and influenced by a wide range of biological processes.

Predictive factors for successful testicular biopsy.

INTRODUCTION: Infertility, the inability to conceive, constitutes a major problem in modern societies. It affects 10 to 15 percent of couples in the United States. Evaluation of infertile men is usually complex and often demands a testicular biopsy. MATERIALS AND METHODS: We reviewed all azoospermic men submitted to testicular biopsy, in our center, during infertility investigation between January 2015 and December 2021. RESULTS: A total of 117 patients with a mean age of 36.5 was considered. Biopsy was positive, as defined by the presence of viable spermatozoids by microscopy, in 48.7% of patients (n = 57). Patients were divided in two separate groups based on positive (PB) or negative biopsy (NB) and compared. PB-group had normal serum total testosterone levels and higher than NB-group (3.7 ng/mL vs. 2.85 ng/mL, p = 0.021), and normal serum FSH levels and lower than NB-group (6.0 mIU/mL vs. 16.0 mIU/mL, p < 0.001). The groups were similar concerning serum LH levels (3.9 mIU/mL vs. 6.3 mIU/mL, p = 0.343. CONCLUSIONS: Predicting outcomes of testicular biopsy is a difficult task. Our study found that men with normal testicular volume, normal levels of testosterone and FSH and those with type 1 diabetes mellitus had a higher probability of positive testicular biopsy.

High Incidence of Respiratory Syncytial Virus in Children with Community-Acquired Pneumonia from a City in the Brazilian Pre-Amazon Region.

INTRODUCTION: Although fewer children have been affected by the severe form of the coronavirus disease 2019 (COVID-19), community-acquired pneumonia (CAP) continues to be the leading global cause of child hospitalizations and deaths. AIM: This study investigated the incidence of respiratory syncytial virus (RSV) as well its subtypes (RSV A and B), adenovirus (ADV), rhinovirus (HRV), metapneumovirus (HMPV), coronavirus (NL63, OC43, 229E and HKU1), parainfluenza virus subtypes (PI1, PI2 and PI3), bocavirus and influenza A and B viruses (FluA and FluB) in children diagnosed with CAP during the COVID-19 pandemic. METHODS: A total of 200 children with clinically confirmed CAP were initially recruited, of whom 107 had negative qPCR results for SARS-CoV-2 and were included in this study. Viral subtypes were identified using a real-time polymerase chain reaction in the nasopharyngeal swab samples. RESULTS: Viruses were identified in 69.2% of the patients. RSV infections were the most frequently identified (65.4%), with type RSV B being the most prevalent (63.5%). In addition, HCoV 229E and HRV were detected in 6.5% and 3.7% of the patients, respectively. RSV type B was associated with severe acute respiratory infection (ARI) and a younger age (less than 24 months). CONCLUSIONS: New strategies for preventing and treating viral respiratory infections, particularly RSV infections, are necessary.

Prevalence of Polypharmacy of Older People in a Large Brazilian Urban Center and its Associated Factors.

BACKGROUND: With the aging population comes greater risks associated with polypharmacy, a significant public health problem. OBJECTIVE: This study aimed to identify the prevalence of polypharmacy and its associated factors through Comprehensive Geriatric Assessment (CGA) among older adults treated in primary health care (PHC) in a large Brazilian urban center. METHODS: We conducted a cross-sectional study with a random sampling of 400 older adults using primary health care. Polypharmacy was defined as the cumulative use of five or more daily medications. An assessment of a sociodemographic and health survey, fear of falling, and physical disabilities affecting activities of daily living and instrumental activities of daily living was conducted. RESULTS: The mean age was 75.23 (SD: 8.53) years. The prevalence of polypharmacy and hyperpolypharmacy was 37% (n = 148) and 1% (n = 4), respectively. The adjusted logistic regression showed that participants with chronic non-communicable diseases (CNCDs) (OR = 9.24; p = 0.003), diabetes (OR = 1.93; p = 0.003), and obesity (OR = 2.15; p = 0.005) were associated with a greater propensity to use polypharmacy. CONCLUSION: Our results show that older adults with CNCDs, diabetes, and obesity were more likely to use polypharmacy. The results reinforce the importance of using CGA in clinical practice in PHC.

SARS-CoV-2 infection in kidney transplant recipients: clinical impact and outcomes - a single center experience / Infecção por SARS-CoV-2 em receptores de transplante renal: impacto clínico e outcomes - uma experiência de centro único

ABSTRACT Introduction: Kidney transplant recipients are a subgroup of patients at higher risk of critical forms of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) infection and poor outcomes due to immunosuppression treatment. Herein, we present data from a single center cohort of kidney transplant recipients with SARS-CoV-2 infection. Methods: In a prospective study, baseline characteristics, clinical features, antiviral and immunosuppression management were compared between outpatients and hospitalized patients, during a one-year period. Results: Seventy-seven kidney transplant recipients were analyzed, including outpatients and hospitalized patients, with a median age of 57.7 (IQR 49.7-64.9) years. Twenty-eight (36.4%) were managed as outpatients, while 49 (63.6%) patients required hospital admission. Among hospitalized patients, 18.4% were admitted in ICU, 49% had AKI, and 20.4% died. Immunosuppression adjustments were performed in 95.9% of hospitalized patients, with dose of anti-metabolites adjusted in 83.7%, mTOR inhibitors in 14.3%, calcineurin inhibitors in 12.2%, and corticosteroid therapy in 81.6%. Conclusion: Among hospitalized patients, immunosuppression management included reduction or withdrawal of anti-metabolite and increase of corticosteroid dose. AKI occurred in almost half of patients and mortality in hospitalized patients reached 20%, reflecting greater disease severity than the general population.

RESUMO Introdução: Receptores de transplante renal são um subgrupo de doentes com maior risco de apresentar formas críticas de infecção por Síndrome Respiratória Aguda Grave pelo Coronavirus-2 (SARS-CoV-2) e piores outcomes devido ao tratamento imunossupressor. Aqui, apresentamos dados de uma coorte de um único centro de receptores de transplante renal com infecção por SARS-CoV-2. Métodos: Num estudo prospectivo, características basais, características clínicas, adaptação da terapêutica antiviral e de imunossupressão foram comparados entre doentes seguidos em ambulatório e doentes hospitalizados durante um período de um ano. Resultados: Foram analisados setenta e sete receptores de transplante renal, incluindo doentes de ambulatório e hospitalizados, com idade média de 57,7 (IIQ 49,7-64,9) anos. Vinte e oito (36,4%) foram tratados em ambulatório enquanto 49 (63,6%) doentes necessitaram de internação hospitalar. Entre os doentes hospitalizados, 18,4% foram admitidos na UTI, 49% apresentaram LRA, e 20,4% morreram. Foram realizados ajustes de imunossupressão em 95,9% dos pacientes hospitalizados, com dose de antimetabólitos ajustada em 83,7%, inibidores de mTOR em 14,3%, inibidores de calcineurina em 12,2%, e terapia com corticosteroides em 81,6%. Conclusão: Entre os pacientes hospitalizados, a optimização da terapêutica imunossupressora incluiu redução ou retirada de antimetabólito e aumento da dose de corticosteroides. A LRA ocorreu em quase metade dos pacientes e a mortalidade em pacientes hospitalizados atingiu 20%, refletindo uma maior gravidade da doença em relação à população em geral.

Complex Regional Pain Syndrome after Carpal Tunnel Syndrome Surgery: A Systematic Review.

Background: Carpal tunnel syndrome (CTS) is the most common peripheral nerve entrapment. One of the most devastating complications is complex regional pain syndrome. Objectivities: The aim of this study was to systematically analyze available evidence about complex regional pain syndrome after carpal tunnel syndrome surgery (CTSS), its risks, associated factors, and treatments. Material and Methods: Research conducted from 1962 through December 31, 2018, in the following databases: PubMed, Web of Science, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials. The quality assessment of the methodology followed the definitions by the Oxford Centre for Evidence-Based Medicine 2011 Levels of Evidence. The GRADE system (Grades of Recommendation, Assessment, Development, and Evaluation) was applied to evaluate the efficacy of the stellate ganglion block, one of the most cited and recurrent treatments. Results: Of the 246 studies retrieved, 44 articles were included. Concerning patients' gender, we identified a ratio of 5 females: 3 males. The mean age for women was 57.79, a standard deviation of 14.96, and for men 60.75, a standard deviation of 9.4. Considering the total of primary publications of CTSS outcomes, the accumulated incidence reached the maximum of 0.15 CRPS after CTSS patients/CTSS patients. The known risk factors for CRPS after CTSS: female gender, from the fifth decade of life, tourniquet time, immobilization and surgery on dominant hand. Conclusion: CRPS affects 2-5% of people undergoing CTSS. Its diagnosis is still a challenge and its risk factors are unclear, although it seems more likely to affect women, in the dominant hand. The most used treatments include physiotherapy and stellate ganglion block. Most patients show improvement of symptoms within one year. Further clinical trials comparing treatment modalities are required.

Effects of Baru Almond Oil (Dipteryx alata Vog.) Treatment on Thrombotic Processes, Platelet Aggregation, and Vascular Function in Aorta Arteries.

Background: This study assessed the effects of Baru (Dipteryx alata Vog.) almond oil supplementation on vascular function, platelet aggregation, and thrombus formation in aorta arteries of Wistar rats. Methods: Male Wistar rats were allocated into three groups. The control group (n = 6), a Baru group receiving Baru almond oil at 7.2 mL/kg/day (BG 7.2 mL/kg, n = 6), and (iii) a Baru group receiving Baru almond oil at 14.4 mL/kg/day (BG 14.4 mL/kg, n = 6). Baru oil was administered for ten days. Platelet aggregation, thrombus formation, vascular function, and reactive oxygen species production were evaluated at the end of treatment. Results: Baru oil supplementation reduced platelet aggregation (p < 0.05) and the production of the superoxide anion radical in platelets (p < 0.05). Additionally, Baru oil supplementation exerted an antithrombotic effect (p < 0.05) and improved the vascular function of aorta arteries (p < 0.05). Conclusion: The findings showed that Baru oil reduced platelet aggregation, reactive oxygen species production, and improved vascular function, suggesting it to be a functional oil with great potential to act as a novel product for preventing and treating cardiovascular disease.

Desenvolvimento do pensamento crítico nos estudantes de enfermagem / Desarrollo del pensamiento crítico en los estudiantes de enfermería / Development of critical thinking in nursing students

Objetivo: analisar o pensamento crítico desenvolvido pelos estudantes participantes de um componente curricular do curso de graduação em enfermagem. Método: estudo de natureza qualitativa, observacional e comparativa, antes e após a intervenção. Foi aplicado questionário sociodemográfico e texto-estímulo em dois momentos. A amostra foi constituída por 48 estudantes que frequentaram a unidade curricular de Pensamento Crítico em Enfermagem. Resultados: no primeiro momento, os estudantes reconheceram o pensamento crítico como importante na tomada de decisão e no desenvolvimento de competências, educar para pensar. No segundo momento, os comentários indicaram um papel ativo da escola, e a informação e o conhecimento do estudante são acurados no contexto formativo. Considerações finais: no pensamento crítico desenvolvido pelos estudantes participantes do componente curricular do curso de enfermagem constatou-se alteração significativa no léxico dos dois momentos, houve desenvolvimento de habilidades de pensamento crítico, das quais destacamos a interpretação, a argumentação, a análise e avaliação.

Objetivo: analizar el pensamiento crítico desarrollado por estudiantes que participan en un componente curricular de la carrera de licenciatura en enfermería. Método: estudio cualitativo, observacional y comparativo, antes y después de la intervención. Se aplicó un cuestionario sociodemográfico y un "texto estímulo" en dos momentos. La muestra estuvo constituída por 48 estudiantes que cursaron la unidad curricualar de Pensamiento Crítico en Enfermería. Resultados: en un primer momento, los estudiantes reconocieron el pensamiento crítico como importante en la toma de decisiones y en el desarrollo de habilidades, educar para pensar. En un segundo momento, los comentarios indicaron un papel activo de la escuela, y la información y los conocimientos del alumno son precisos en el contexto formativo. Consideraciones finales: en el pensamiento crítico desarrollado por los estudiantes que participaron en el componente curricular de la carrera de enfermería, hubo un cambio significativo en el léxico de los dos momentos, hubo un desarrollo de habilidades de pensamiento crítico, de las cuales se destacan la interpretación, argumentación, análisis y evaluación.

Objective: To analyse the critical thinking developed by students participating in a curricular component of undergraduate nursing programmes. Method: Qualitative, observational and comparative study before and after the intervention. A sociodemographic questionnaire and text stimulus were applied in two phases. The sample consisted of 48 students enrolled in the Critical Thinking In Nursing course. Results: In the first phase, the students recognized critical thinking as important in decision-making, in the development of skills and in the process of educating them to think. In the second phase, the comments indicated an active role of the school, and the knowledge of students improved in the formative context. Final considerations: In the critical thinking developed by the students who participated in the curricular component of the nursing programme, a significant change was found in the lexicon in both phases, and critical thinking skills were developed, in particular interpretation, argumentation, analysis, and evaluation.

Insulin-degrading enzyme: an ally against metabolic and neurodegenerative diseases.

Insulin-degrading enzyme (IDE) function goes far beyond its known proteolytic role as a regulator of insulin levels. IDE has a wide substrate promiscuity, degrading several proteins such as amyloid-ß peptide, glucagon, islet amyloid polypeptide (IAPP), and insulin-like growth factors, which have diverse physiological and pathophysiological functions. Importantly, IDE plays other non-proteolytic functions such as: a chaperone/dead-end chaperone, an E1-ubiquitin activating enzyme, and a proteasome modulator. It also responds as a heat shock protein, regulating cellular proteostasis. Notably, amyloidogenic proteins such as IAPP, amyloid-ß, and α-synuclein have been reported as substrates for IDE chaperone activity. This is of utmost importance as failure of IDE may result in increased protein aggregation, a key hallmark in the pathogenesis of beta cells in type 2 diabetes mellitus and of neurons in neurodegenerative diseases such as Alzheimer's and Parkinson's disease. In this review, we focus on the biochemical and biophysical properties of IDE and the regulation of its physiological functions. We further raise the hypothesis that IDE plays a central role in the pathological context of dysmetabolic and neurodegenerative diseases and discuss its potential as a therapeutic target. © 2021 The Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.

IMPORTANCE trial: a provisional study-design of a single-center, phase II, double-blinded, placebo-controlled, randomized, 4-week study to compare the efficacy and safety of intranasal esketamine in chronic opioid refractory pain.

Background:  Cancer is the second leading cause of death globally. Up to 86% of advanced cancer patients experience significant pain, while 10-20% live in chronic pain. Besides, increasing prescription of opioids resulted in 33,000 deaths in the US in 2015. Both reduce patients' functional status and quality of life. While cancer survival rates are increasing, therapeutic options for chronic opioid refractory pain are still limited. Esketamine is the s-enantiomer of ketamine, with superior analgesic effect and less psychotomimetic side effects. Intranasal esketamine was approved by the FDA for treatment-resistant depression. However, its use in chronic cancer pain has never been tested. Therefore, we propose a phase II, randomized, placebo-controlled trial to evaluate the efficacy and safety of intranasal esketamine in chronic opioid refractory cancer pain. Methods and analysis: We will recruit 120 subjects with chronic opioid refractory pain, defined as pain lasting more than 3 months despite optimal therapy with high dose opioids (>60 mg morphine equivalent dose/day) and optimal adjuvant therapy. Subjects will be randomized into two groups: intranasal esketamine (56mg) and placebo. Treatment will be administered twice a week for four consecutive weeks. The primary outcome is defined as reduction in the Numeric Pain Rating Scale (NPRS) after first application. Secondary outcomes include NPRS reduction after four weeks, the number of daily morphine rescue doses, functional status and satisfaction, and depression. Conclusion: This study may extend therapeutic options in patients with chronic pain, thus improving their quality of life and reducing opioid use. Trial registration: Clinical Trials.gov, NCT04666623. Registered on 14 December 2020.

Virtual Screening of Natural Products Database.

Constant research on natural products has generated, over time, a large number of compounds with the potential to be evaluated in several biological tests and subsequently have been cataloged in databases that allow other researchers to perform virtual screenings of activity in various biological systems. This considerably reduces the time for the development of new drugs. This review describes the main databases of natural products available for searching bioactive compounds. It also describes the main features of virtual screening strategies for the identification of molecules with the potential to be used as new drugs. In addition, a search was made in the Web of Science database, using the search term "Virtual screening of natural products databases" from 2003 to 2018. The search criterion resulted in 230 articles, which had their abstracts evaluated with pertinence to the criteria required for this work, which are: a) be a research article; b) performing a virtual screening on databases of natural products or containing natural products; and c) works that identified drug candidate molecules. Based on these criteria, the bibliographic review on the topic was excluded. After this analysis, 104 works were selected for this review. We selected relevant papers describing the potential drug candidates that were distributed in 15 classes, of which the anticancer, antibacterial and anti-inflammatory hits were the most abundant. The works showing efforts to search for new molecules against various other diseases in distinct biological systems were also described. In this way, this work shows an overview of several methodologies and we hope they can help and inspire the development of new research to improve people's quality of life.

The fear of falls in the caregivers of institutionalized elders / El miedo a caer entre los profesionales que atienden a ancianos institucionalizados / O medo de queda nos profissionais que cuidam de idosos institucionalizados

ABSTRACT Aims To understand how the fear of falls emerges and manifests itself in caregivers of institutionalized elders. Method It is a qualitative study, based on the Grounded Theory and carried out with 24 informal caregivers, 5 nurses, 2 physicians and 2 directors of two Portuguese nursing homes. Data collection took place through interviews, participant observation, and documentation analysis, between October 2016 and January 2018. Data was collected and analyzed simultaneously, following the stages of open, axial, and selective coding. Results The comparative analysis of the findings identified the conceptual category "Fear of falls in the caregivers of institutionalized elders". The main category is associated with the categories: maintaining safety, hidden fear of falls, the perceived self-efficacy in the prevention of falls, falls and interpersonal relations, previous experiences, and team support. Conclusions The fear has an influence on the self-efficacy perceived in the prevention of falls; the quality of the teamwork, in turn, is affected by previous negative experiences and by the support of the team.

RESUMEN Objetivo Este estudio tuvo como objetivo comprender cómo surge y se manifiesta el miedo a caerse en los cuidadores de ancianos institucionalizados. Método Estudio cualitativo apoyado por Grounded Theory realizado con 24 cuidadores informales, 5 enfermeras, 2 médicos y 2 directores de dos hogares de ancianos portugueses. Los hallazgos fueron recopilados con entrevistas, observación participante y análisis de la documentación, entre octubre de 2016 y enero de 2018. Los datos se recopilaron y analizaron simultáneamente, siguiendo las etapas de codificación abierta, axial y selectiva. Resultados El análisis comparativo de los hallazgos identificó la categoría conceptual: el miedo a caer en los cuidadores de ancianos institucionalizados, con categorías asociadas: mantenimiento de la seguridad, miedo oculto a las caídas, autoeficacia percibida en prevención y caídas, caídas y relaciones interpersonales, experiencias previas y apoyo al equipo. Conclusiones El miedo afecta la autoeficacia percibida en la prevención de caídas; La calidad del trabajo en equipo está influenciada por experiencias negativas previas y el apoyo del equipo.

RESUMO Objetivo Este estudo teve por objetivo compreender como surge e se manifesta o medo de queda nos cuidadores de idosos institucionalizados. Método Estudo Qualitativo suportado pela Grounded Theory realizado com 24 cuidadores informais, 5 enfermeiros, 2 médicos e 2 diretores de duas Instituições de Longa Permanência para Idosos Portuguesas. A colheita dos achados foi feita com entrevistas, observação participante e análise da documentação, entre outubro de 2016 e janeiro de 2018. Os dados foram coletados e analisados simultaneamente, seguindo as etapas da codificação aberta, axial e seletiva. Resultados A análise comparativa dos achados identificou a categoria conceitual: Medo de queda nos cuidadores de idosos institucionalizados, com as categorias associadas: manter a segurança, medo oculto de queda, autoeficácia percebida na prevenção e quedas, a queda e as relações interpessoais, experiências anteriores e suporte da equipe. Conclusões O medo afeta a autoeficácia percebida na prevenção de quedas; a qualidade de trabalho em equipa e é influenciado pelas experiências anteriores negativas e pelo suporte da equipa.

Validation of the international 7-item falls efficacy scale in portuguese community-dwelling older adults / Validación de la escala falls efficacy scale internacional de 7 ítems en ancianos portugueses residentes en la comunidad / Validação da falls efficacy scale internacional 7 itens em idosos portugueses residentes na comunidade

ABSTRACT Objective to determine the psychometric properties of the international 7-item Falls Efficacy Scale. Method a psychometric study. Convenience sample consisting of 170 older adults living in the Madeira Autonomous Region, Portugal. A two-part instrument was used (sociodemographic characterization and the Falls Efficacy Scale-International-Portugal). The starting point was the translation and transcultural adaptation already carried out for the Falls Efficacy Scale - International (16 items). Construct validity (factorial analysis and discriminant validity) and the reliability (Cronbach's α) of the 7-item scale were evaluated. Previous authorization was obtained from the Ethics Commission and from the people involved. Results in the exploratory factorial analysis, the International 7-item Falls Efficacy Scale presents an explained variance of 65.8%. The Spearman's correlation between the score obtained based on the 7 items and the score obtained based on the 16 items is significant and very strong (r=0.987, p<0.0001). Internal consistency was 0.958. Conclusion the validity and reliability study of the International 7-item Falls Efficacy Scale revealed that it is an adequate scale for the evaluation of the fear of falling in the community-dwelling older adults.

RESUMEN Objetivo determinar las propiedades psicométricas de la escala Falls Efficacy Scale Internacional de 7 ítems. Método estudio psicométrico. Muestra por conveniencia de 170 ancianos que viven en la Región Autónoma da Madeira, Portugal. Se empleó un instrumento constituido por dos partes (caracterización sociodemográfica y la escala Falls Efficacy Scale Internacional - Portugal). Se partió de la traducción y adaptación transcultural ya realizada de la escala Falls Efficacy Scale Internacional (16 ítems). Se evaluó la validez de constructo (análisis factorial y validez discriminante) y la confiabilidad (α de Cronbach) de la escala de 7 ítems. Previamente se obtuvo la autorización de la Comisión de Ética y de las personas involucradas. Resultados en el análisis factorial exploratorio, la escala Falls Efficacy Scale Internacional de 7 ítems presenta una varianza explicada del 65,8%. La correlación de Spearman entre la puntuación obtenida sobre la base de los 7 ítems y la obtenida sobre la base de los 16 ítems es significativa y muy fuerte (r=0,987, p<0,0001). La consistencia interna fue de 0,958. Conclusión el estudio de la validez y la confiabilidad de la escala Falls Efficacy Scale Internacional de 7 ítems reveló que es una escala adecuada para evaluar el miedo a caer en el anciano que vive en la comunidad.

RESUMO Objetivo determinar as propriedades psicométricas da Falls Efficacy Scale Internacional 7 itens. Método estudo psicométrico. Amostra de conveniência, de 170 idosos residentes em Região Autónoma da Madeira, Portugal. Recorreu-se a instrumento constituído por duas partes (caracterização sociodemográfica e a Falls Efficacy Scale Internacional Portugal). Partiu-se da tradução e adaptação transcultural já realizada para a Falls Efficacy Scale Internacional (16 itens). Avaliou-se a validade de constructo (análise fatorial e validade discriminante) e a confiabilidade (α de Cronbach) da escala de 7 itens. Obteve-se previamente autorização da Comissão de Ética e das pessoas envolvidas. Resultados na análise fatorial exploratória a Falls Efficacy Scale Internacional 7 itens apresenta uma variância explicada de 65,8%. A correlação de Spearman entre a pontuação obtida com base nos 7 itens e a pontuação obtida com base nos 16 itens é significativa e muito forte (r=0.987, p<0.0001). A consistência interna foi de 0,958. Conclusão o estudo da validade e a confiabilidade da Falls Efficacy Scale Internacional 7 itens revelou ser uma escala adequada para a avaliação do medo de cair na pessoa idosa residente na comunidade.

The importance of a training program on active aging from the perspective of elderly individuals / Importância de um programa formativo sobre envelhecimento ativo na perspectiva das pessoas idosas

ABSTRACT Objective: to assess the results of a training program focused on the well-being of elderly individuals from the perspective of users, through the opinion on the program impact on their active aging. Methods: a qualitative research, carried out from an intentional sample, consisting of 10 elderly women. Interview conducted by focus group, recorded and transcribed, which constituted the corpus of analysis. Lexical analysis of textual data was performed using the Alceste software. Results: from the analysis, three classes emerged: 1) Health-Activity; 2) Activity-Expectation; 3) Mind-Body Unit. The Activity-Expectation class stands out. Conclusions: the research revealed that elderly individuals consider it important to have expectation, which results in satisfaction and involvement with life as well as the ability to remain active in a perspective of mind-body unit. Future projects should focus on enhancing mental and physical functions to promote active and healthy aging.

RESUMO Objetivo: avaliar os resultados de um programa formativo focado no bem-estar do idoso na perspectiva dos utilizadores, por meio da opinião sobre o impacto do programa no seu envelhecimento ativo. Métodos: pesquisa qualitativa, realizada a partir de uma amostra intencional, constituída por 10 mulheres idosas. Entrevista realizada por focus group, gravada e transcrita, a qual constituiu o corpus da análise. A análise lexical dos dados textuais foi realizada por meio do software Alceste. Resultados: da análise, emergiram três classes: 1) Saúde-Atividade; 2) Atividade-Expectativa; 3) Unidade Mente-Corpo. Destaca-se a classe Atividade-Expectativa. Conclusões: a pesquisa revelou que os idosos consideram ser importante ter expectativa, que se concretiza na satisfação e envolvimento com a vida, bem como a capacidade de se manterem ativos em uma perspectiva da unidade mente-corpo. Os projetos futuros devem focar na estimulação das funções mentais e físicas, para promoverem envelhecimento ativo e saudável.

Generalized anxiety disorder and prevalence of suicide risk among medical students / Prevalência do transtorno de ansiedade generalizada e do risco de suicídio em estudantes de medicina

Abstract: Introduction: Generalized anxiety disorder (GAD) is a common pathology in modern life. Furthermore, Brazil ranks among one of the countries in Latin America with the highest increase in the number of suicides. Objective: The goal of this study is to evaluate the prevalence of GAD and suicide risk and their association in medical students from Belém - PA. Methods: The observational, cross-sectional and quantitative study included undergraduate medical students attending the 1st, 3rd and 5th years of Universidade do Estado do Pará as subjects of this research, totaling 153 students. It used a protocol created by the authors and the Mini International Neuropsychiatric Interview. The software BioEstat® 5.3 was used to perform the statistical analysis. Results: 52 (32,7%) of the 159 students have GAD and 48 (30,2%) pose a suicide risk, of which 18 have a mild risk (11,3%), 17 a moderate risk (10,7%) and 13 a high risk (8,2%). 46,7% and 50% of the 1st and 3rd-year students, respectively, have higher risk of suicide, which could be related to the competition faced during the University admission process and also during the first years of the clinical cycle. Of the 5th year students who pose a suicide risk, only 21,7% have high risk. Conclusion: It can be observed that GAD and suicide risk show high prevalence among medical students, which has to be investigated and treated aiming to reduce the impacts of those disorders on health professionals and students.

Resumo: Introdução: O transtorno de ansiedade generalizada (TAG) é uma patologia comum da modernidade. Além disso, o Brasil figura entre um dos países da América Latina com o maior aumento do número de suicídios. Objetivo: Este estudo teve como objetivo avaliar a prevalência de TAG e risco de suicídio e a associação entre eles em estudantes de Medicina de Belém, no Pará. Métodos: O estudo observacional, transversal e quantitativo teve como sujeitos da pesquisa graduandos do curso de Medicina que estavam matriculados no primeiro, terceiro e quinto anos na Universidade do Estado do Pará, totalizando 159. Utilizaram-se questionário de autoria dos pesquisadores e o Mini International Neurophsychiatric Interview, sendo a análise estatística feita com o software BioEstat® 5.3. Resultados: Dos 159 estudantes, 52 (32,7%) apresentaram TAG; e 48 (30,2%), risco de suicídio, dos quais 18 tiveram risco leve (11,3%); 17, risco moderado (10,7%); e 13, risco elevado (8,2%). Dos alunos, 46,7% e 50%, respectivamente do primeiro e terceiro anos, apresentaram risco elevado de suicídio, fato que pode estar associado com a pressão do vestibular e do início do ciclo clínico. Dos alunos do quinto ano com risco de suicídio, somente 21,7% apresentaram risco elevado. Conclusão: Percebe-se uma importante taxa de TAG e de risco de suicídio entre os estudantes de Medicina, o que precisa ser investigado e trabalhado para minimizar os impactos desses transtornos nos discentes.

Evaluation of the effectiveness of an intervention in a health team to prevent falls in hospitalized elderly people / Evaluación de eficacia de una intervención en el equipo para prevenir caídas del anciano hospitalizado / Avaliação da eficácia de uma intervenção na equipe para prevenir quedas ao idoso hospitalizado

ABSTRACT Objective: To evaluate the effectiveness of an intervention program in practices and behaviors of a health team to prevent falls in hos pitalized elderly people. Method: This was an action, mixed-methods, and longitudinal study that applied an intervention based on TeamSTEPPS®, and organized into five domains: team training, communication, leadership, monitoring, and mutual support. The population was nurses and nursing aides who worked at the medical service of a Portuguese hospital center. Data were obtained by consulting process records and interviews, and by applying the Scale of Practices and Behaviors of Teams for Fall Prevention. Results: There was improvement in all indicators of the scale, with evident progress in discussion of risk factors and preventive measures to be implemented. Conclusion: This intervention promoted decision-making regarding the preventive measures to be applied to each elderly person and improved communication and the interest in identifying the causes of falls to prevent their recurrence.

RESUMEN Objetivo: Evaluar la eficacia de un programa de intervención en prácticas y conductas del equipo de salud para prevenir caídas de ancianos hospitalizados. Método: Estudio de investigación-acción, mixto y longitudinal, con aplicación de una intervención basada en el "TeamSTEPPS®", organizada en cinco dominios: formación del equipo, comunicación, liderazgo, monitoreo y soporte mutuo. Población constituida por enfermeros y auxiliares de un servicio de medicina en un centro hospitalario portugués. Datos obtenidos mediante consulta de los procesos, entrevistas y aplicación de escala de evaluación de las prácticas y conductas de los equipos en la gestión del riesgo de caída en ancianos. Resultados: Los resultados de la aplicación de la escala de prácticas y conductas de los equipos en la gestión del riesgo de caída de los ancianos apuntan a una mejora en todos sus indicadores, claramente expresada en la discusión de factores de riesgo y medidas preventivas a implementarse. Conclusión: La intervención promueve la toma de decisiones sobre medidas preventivas a aplicarse con cada anciano, mejora la comunicación y el interés en identificar las causas de caída para prevenir su reiteración.

RESUMO Objetivo: Avaliar a eficácia de um programa de intervenção nas práticas e comportamentos da equipe de saúde para prevenir a queda a idosos hospitalizados. Método: Estudo de investigação-ação, misto e longitudinal, com aplicação de uma intervenção baseada no "TeamSTEPPS®", organizada em cinco domínios: formação da equipe, comunicação, liderança, monitorização e suporte mútuo. A população foi constituída por enfermeiros e auxiliares de um serviço de medicina de um centro hospitalar português. Os dados foram obtidos por consulta aos processos, entrevistas e pela aplicação da escala de avaliação das práticas e comportamentos das equipes na gestão do risco de quedas de idosos. Resultados: Os resultados da aplicação da escala de práticas e comportamentos das equipes na gestão do risco de queda dos idosos apontam para uma melhoria em todos os indicadores dessa escala, com claras melhorias na discussão dos fatores de risco e das medidas preventivas a implementar. Conclusão: A intervenção promove a tomada de decisão sobre as medidas preventivas a serem aplicadas a cada idoso, melhora a comunicação e o interesse em identificar as causas de quedas, para prevenir a sua recorrência.

Remote ischemic conditioning improves rat brain antioxidant defense in a time-dependent mechanism

ABSTRACT Purpose To clarify the best protocol for performing remote ischemic conditioning and to minimize the consequences of ischemia and reperfusion syndrome in brain, the present study aimed to evaluate different time protocols and the relation of the organs and the antioxidant effects of this technique. Methods The rat's left femoral artery was clamped with a microvascular clamp in times that ranged from 1 to 5 minutes, according to the corresponding group. After the cycles of remote ischemic conditioning and a reperfusion of 20 minutes, the brain and the left gastrocnemius were collected. The samples were used to measure glutathione peroxidase, glutathione reductase and catalase levels. Results In the gastrocnemius, the 4-minute protocol increased the catalase concentration compared to the 1-minute protocol, but the latter increased both glutathione peroxidase and glutathione reductase compared to the former. On the other hand, the brain demonstrated higher catalase and glutathione peroxidase in 5-minute group, and the 3-minute group reached higher values of glutathione reductase. Conclusions Remote ischemic conditioning increases brain antioxidant capacity in a time-dependent way, while muscle presents higher protection on 1-minute cycles and tends to decrease its defence with longer cycles of intermittent occlusions of the femoral artery.

Virtual screening and assessment of anticancer potential of selenium-based compounds against HL-60 and MCF7 cells.

Aim: Selenium-based compounds have antitumor potential. We used a ligand-based virtual screening analysis to identify selenoglycolicamides with potential antitumor activity. Results & Conclusion: Compounds 3, 6, 7 and 8 were selected for in vitro cytotoxicity tests against various cell lines, according to spectrophotometry results. Compound 3 presented the best cytotoxicity results against a promyelocytic leukemia line (HL-60) and was able to induce cell death at a frequency similar to that observed for doxorubicin. The docking study showed that compound 3 has good interaction energies with the targets caspase-3, 7 and 8, which are components of the apoptotic pathway. These results suggested that selenium has significant pharmacological potential for the selective targeting of tumor cells, inducing molecular and cellular events that culminate in tumor cell death.