Advances in Tissue Culture and Transformation Studies in Non-model Species: Passiflora spp. (Passifloraceae).

In this chapter, we report advances in tissue culture applied to Passiflora. We present reproducible protocols for somatic embryogenesis, endosperm-derived triploid production, and genetic transformation for such species knowledge generated by our research team and collaborators in the last 20 years. Our research group has pioneered the work on passion fruit somatic embryogenesis, and we directed efforts to characterize several aspects of this morphogenic pathway. Furthermore, we expanded the possibilities of understanding the molecular mechanism related to developmental phase transitions of Passiflora edulis Sims. and P. cincinnata Mast., and a transformation protocol is presented for the overexpression of microRNA156.

Green spaces and respiratory, cardiometabolic, and neurodevelopmental outcomes: An individual-participant data meta-analysis of >35.000 European children.

Studies evaluating the benefits and risks of green spaces on children's health are scarce. The present study aimed to examine the associations between exposure to green spaces during pregnancy and early childhood with respiratory, cardiometabolic, and neurodevelopmental outcomes in school-age children. We performed an Individual-Participant Data (IPD) meta-analysis involving 35,000 children from ten European birth cohorts across eight countries. For each participant, we calculated residential Normalized Difference Vegetation Index (NDVI) within a 300 m buffer and the linear distance to green spaces (meters) during prenatal life and childhood. Multiple harmonized health outcomes were selected: asthma and wheezing, lung function, body mass index, diastolic and systolic blood pressure, non-verbal intelligence, internalizing and externalizing problems, and ADHD symptoms. We conducted a two-stage IPD meta-analysis and evaluated effect modification by socioeconomic status (SES) and sex. Between-study heterogeneity was assessed via random-effects meta-regression. Residential surrounding green spaces in childhood, not pregnancy, was associated with improved lung function, particularly higher FEV1 (ß = 0.06; 95 %CI: 0.03, 0.09 I2 = 4.03 %, p < 0.001) and FVC (ß = 0.07; 95 %CI: 0.04, 0.09 I2 = 0 %, p < 0.001) with a stronger association observed in females (p < 0.001). This association remained robust after multiple testing correction and did not change notably after adjusting for ambient air pollution. Increased distance to green spaces showed an association with lower FVC (ß = -0.04; 95 %CI: -0.07, -0.02, I2 = 4.8, p = 0.001), with a stronger effect in children from higher SES backgrounds (p < 0.001). No consistent associations were found between green spaces and asthma, wheezing, cardiometabolic, or neurodevelopmental outcomes, with direction of effect varying across cohorts. Wheezing and neurodevelopmental outcomes showed high between-study heterogeneity, and the age at outcome assessment was only associated with heterogeneity in internalizing problems.. This large European meta-analysis suggests that childhood exposure to green spaces may lead to better lung function. Associations with other respiratory outcomes and selected cardiometabolic and neurodevelopmental outcomes remain inconclusive.

Long-term impact of home-based monitoring after an admission for acute decompensated heart failure: a systematic review and meta-analysis of randomised controlled trials.

Background: Patients with heart failure have high rehospitalisation rates and poor cardiovascular outcomes. Home-based monitoring (HBM) has emerged with promising results in different settings. However, its long-term effects on patients recently admitted for acute decompensated heart failure (ADHF) remain uncertain. Methods: We systematically searched PubMed, Embase, and Cochrane Library for randomised controlled trials (RCTs) comparing HBM with usual care (UC) that were published between database inception and June 24, 2023. We included studies with patients admitted for ADHF in the previous 6 months and with a minimum follow-up of 6 months. We excluded studies with patients hospitalised for reasons other than ADHF and studies with disproportional education interventions between arms. Statistical analyses were performed using R software version 4.3.2. We pooled risk ratios (RR) and mean differences (MD) with 95% confidence intervals (CI) for categorical and continuous outcomes, respectively. Cochrane Collaboration's tool for assessing risk of bias in RCTs (RoB 2) was used to assess study quality. Publication bias was assessed via funnel plots and Egger's test, and heterogeneity was assessed through I2 statistics and sensitivity analysis. The protocol for this systematic review and meta-analysis was registered in the International Prospective Register of Systematic Reviews (PROSPERO, CRD42023465359). Findings: We included 16 RCTs comprising 4629 patients, of whom 2393 (51.7%) were randomised to HBM and 3150 (68%) were men. Follow-up ranged from six to fifteen months. As compared with UC, HBM significantly reduced all-cause mortality (RR 0.75; 95% CI 0.61, 0.91; p = 0.005), all-cause hospitalisations (RR 0.82; 95% CI 0.70, 0.97; p = 0.018), cardiovascular (CV) mortality (RR 0.53; 95% CI 0.36, 0.79; p = 0.002), hospitalisations for heart failure (RR 0.75; 95% CI 0.62, 0.91; p = 0.004), and CV hospitalisations (RR 0.72; 95% CI 0.55, 0.95; p = 0.018). There were no significant differences in length of hospital stay (MD 0.97 days; 95% CI -0.90, 2.84; p = 0.308). Interpretation: In patients recently admitted with ADHF, HBM significantly reduces long-term all-cause mortality and hospitalisations, CV mortality and hospitalisations, and hospitalisations for heart failure, as compared with UC. This supports the implementation of HBM as a standard practice to optimise patient outcomes following admissions for ADHF. However, future studies are warranted to evaluate the efficacy and safety of implementing HBM in the real-world setting. Funding: None.

Possibilidades de atuação da Terapia Ocupacional no campo da saúde mental infantojuvenil: bullying e sofrimento psíquico na adolescência / Possibilities of occupational therapy in the field of chlidhood of mental health: bullying and psychic suffering in adolescence / Posibilidades de la terapia occupacional en el ambito de la salud mental infantil y juvenil: buliiyging y sofrimiento psiquico en la adolescencia

O presente trabalho objetiva abordar, por meio de um relato de experiência, as possibilidades de atuação da Terapia Ocupacional no campo da saúde mental infantojuvenil como, por exemplo, diante de situações de bullying e sofrimento psíquico vivenciados por adolescentes. Trata-se do relato de uma experiência vinculada a um projeto de ensino e extensão universitária, realizado em uma escola pública do interior do Estado de SP. As intervenções foram realizadas em três etapas: 1) Roda de conversa e compartilhamento com a equipe escolar; 2) Intervenção em sala de aula e 3) Acolhimento e acompanhamento das demandas emergidas nas etapas 1 e 2. Os resultados apontam que a ação desenvolvida auxiliou os adolescentes a reconhecerem suas potências, assim como a identificarem e lidarem com os fenômenos que lhes geram sofrimento. As estratégias adotadas caminham na direção do que tem sido sugerido e apontado pela literatura como possibilidade de atuação frente à temática do bullying, sendo a Terapia Ocupacional uma das profissões atuantes nesse campo

The present work aims to address, through an experience report, the possibilities of Occupational Therapy in the field of child and adolescent mental health, for example, in situations of bullying and psychological suffering experienced by adolescents. This is the report of an experience linked to a teaching and university extension project, carried out in a public school in the interior of the State of SP. The interventions were carried out in three stages: 1) Conversation and sharing with the school team;2) Intervention in the classroom and 3) Reception and monitoring of the demands that emerged in stages 1 and 2. The results indicate that the developmental action helped adolescents to recognize their strengths, as well as to identify and deal with the phenomena that cause them suffering. The strategies adopted move in the direction of what has been suggested and pointed out in the literature as a possibility of action in the face of bullying, with Occupational Therapy being one of the professions active in this field (AU).

El presente trabajo pretende abordar, a través de un relato de experiencia, las posibilidades de la Terapia Ocupacional en el ámbito de la salud mental infanto-juvenil, por ejemplo, en situaciones de acoso escolar y sufrimiento psicológico que viven los adolescentes. Este es el relato de una experiencia vinculada a un proyecto de enseñanza y extensión universitaria, realizado en una escuela pública del interior del Estado de SP. Las intervenciones se realizaron en tres etapas: 1) Conversación y compartir con el equipo escolar; 2) Intervención en el aula y 3) Recepción y seguimiento de las demandas surgidas en las etapas 1 y 2. Los resultados indican que la acción evolutiva ayudó a los adolescentes a reconocer sus fortalezas, así como a identificar y afrontar los fenómenos que las provocan. sufrimiento. Las estrategias adoptadas van en la dirección de lo sugerido y señalado en la literatura como una posibilidad de actuación frente al acoso escolar, siendo la Terapia Ocupacional una de las profesiones activas en este campo (AU).

Changing Clinical Epidemiology of Plasmodium vivax Malaria as Transmission Decreases: Population-Based Prospective Panel Survey in the Brazilian Amazon.

BACKGROUND: Malarial infections are often missed by microscopy, and most parasite carriers are asymptomatic in low-endemicity settings. Whether parasite detectability and its ability to elicit symptoms change as transmission declines remains unclear. METHODS: We performed a prospective panel survey with repeated measurements on the same participants over 12 months to investigate whether Plasmodium vivax detectability by microscopy and risk of symptoms upon infection varied during a community-wide larviciding intervention in the Amazon basin of Brazil that markedly reduced vector density. We screened 1096 to 1400 residents in the intervention site for malaria by microscopy and quantitative TaqMan assays at baseline and twice during intervention. RESULTS: We found that more P vivax infections than expected from their parasite densities measured by TaqMan assays were missed by microscopy as transmission decreased. At lower transmission, study participants appeared to tolerate higher P vivax loads without developing symptoms. We hypothesize that changes in the ratio between circulating parasites and those that accumulate in the bone marrow and spleen, by avoiding peripheral blood microscopy detection, account for decreased parasite detectability and lower risk of symptoms under low transmission. CONCLUSIONS: P vivax infections are more likely to be subpatent and remain asymptomatic as malaria transmission decreases.

Clinical Trajectories and Long-Term Outcomes of Alcoholic Versus Other Forms of Dilated Cardiomyopathy.

BACKGROUND: Alcoholic cardiomyopathy (ACM) is a form of dilated cardiomyopathy (DCM) occurring secondary to long-standing heavy alcohol use and is associated with poor outcomes, but the cause-specific risks are insufficiently understood. METHOD: Between 1997 and 2018, we identified all patients with a first diagnosis of ACM or DCM. The cumulative incidence of different causes of hospitalisation and mortality in the two groups was calculated using the Fine-Gray and Kaplan-Meier methods. RESULTS: A Total of 1,237 patients with ACM (mean age 56.3±10.1 years, 89% men) and 17,211 individuals with DCM (mean age 63.6±13.8 years, 71% men) were identified. Diabetes (10% vs 15%), hypertension (22% vs 31%), and stroke (8% vs 10%) were less common in ACM than DCM, whereas obstructive lung disease (15% vs 12%) and liver disease (17% vs 2%) were more prevalent (p<0.05). Cumulative 5-year mortality was 49% in ACM vs 33% in DCM, p<0.0001, multivariable adjusted hazards ratio 2.11 (95% confidence interval 1.97-2.26). The distribution of causes of death was similar in ACM and DCM, with the predominance of cardiovascular causes in both groups (42% in ACM vs 44% in DCM). 5-year cumulative incidence of heart failure hospitalisations (48% vs 54%) and any somatic cause (59% vs 65%) were also similar in ACM vs DCM. At 1 year, the use of beta blockers (55% vs 80%) and implantable cardioverter defibrillators (3% vs 14%) were significantly less often used in ACM vs DCM. CONCLUSIONS: Patients with ACM had similar cardiovascular risks and hospitalisation patterns as other forms of DCM, but lower use of guideline-directed cardiovascular therapies and greater mortality.

Dioclea violacea lectin inhibits tumorigenesis and tumor angiogenesis in vivo.

Dioclea violacea seed mannose-binding lectin (DvL) has attracted considerable attention because of its interesting biological activities, including antitumor, antioxidant, and anti-inflammatory activities. This study evaluated the cytotoxic effect of DvL on tumor and normal cells using the mitochondrial activity reduction (MTT) assay, the carcinogenic and anti-carcinogenic activity by the epithelial tumor test (ETT) in Drosophila melanogaster, and the anti-angiogenic effect by the chick embryo chorioallantoic membrane (CAM) assay. Data demonstrated that DvL promoted strong selective cytotoxicity against tumor cell lines, especially A549 and S180 cells, whereas normal cell lines were weakly affected. Furthermore, DvL did not promote carcinogenesis in D. melanogaster at any concentration tested, but modulated DXR-induced carcinogenesis at the highest concentrations tested. In the CAM and immunohistochemical assays, DvL inhibited sarcoma 180-induced angiogenesis and promoted the reduction of VEGF and TGF-ß levels at all concentrations tested. Therefore, our results demonstrated that DvL is a potent anticancer, anti-angiogenic, and selective cytotoxic agent for tumor cells, suggesting its potential application as a prototype molecule for the development of new drugs with chemoprotective and/or antitumor effects.

Pedunculagin and tellimagrandin-I stimulate inflammation and angiogenesis and upregulate vascular endothelial growth factor and tumor necrosis factor-alpha in vivo.

Pedunculagin (PD) and tellimagrandin-I (TL), isolated from Myrciaria cauliflora seeds and Eucaliptus microcorys leaves, respectively, have attracted great attention owing to their relevant biological activities, such as antitumor, antioxidant, and hepatoprotective activities. This study investigated the angiogenic potential of PD and TL using a chick embryo chorioallantoic membrane (CAM) assay. Using the CAM assay, our results showed that both PD and TL promoted a significant increase in the number and caliber of blood vessels, the thickness of the CAM, and the presence of fibroblasts and inflammatory cells. Moreover, an increase of tumor necrosis factor-α and vascular endothelial growth factor was observed in the CAM treated with PD and TL, indicating the induction of angiogenic factors. Thus, the remarkable profile of PD and TL in inducing angiogenesis opens up new perspectives for their potential utilization in different therapeutic approaches involving neovascularization.

Tired therapists: from the precariousness of work to the precariousness of care in the autism industry / Terapeutas cansadas: da precariedade do trabalho à precariedade da assistência na indústria do autismo

The specialized therapy for skill acquisition model for children, especially autistic ones, is growing under neoliberal logic. Health professionals experience the precariousness of their work, with repercussions on the care of their health and that of children and families. To deepen the understanding of such aspects, this qualitative, documentary and retrospective research analyzed 131 reports of therapists on social media, under the conditions, dimensions and precariousness of work and historical dimensions, politics and contemporary challenges of care. The results show five themes about the precariousness of work, and three addressing violence and violation of children's rights, institutionalization and the precariousness of relationships. It discusses how the relationship between precarious work and assistance in the "autism industry" affects professionals, children and their families. In order to overcome historical institutionalizing behaviors and promote effective care, integrated with the children's daily experiences and demands, the urgency of the involvement of everyone who is interested in this issue is discussed in order to find dignified solutions in view of the seriousness of the problem at hand.

O modelo de terapias especializadas para aquisição de habilidades para crianças, especialmente autistas, está crescendo sob a lógica neoliberal. Profissionais da saúde vivenciam a precarização do seu trabalho, com repercussões no cuidado de sua saúde e das crianças e famílias. Para aprofundar a compreensão de tais aspectos, esta pesquisa qualitativa, documental e retrospectiva, analisou 131 relatos de terapeutas de uma mídia social, sob as condições, dimensões e precarização do trabalho e dimensões históricas, políticas e desafios contemporâneos da assistência. Os resultados evidenciam cinco temas sobre a precarização do trabalho, e três abordando violência e violação dos direitos das crianças, institucionalização e a precarização das relações. Discute-se como a relação entre trabalho precário e assistência na "indústria do autismo" afeta profissionais, crianças e suas famílias. Para superar condutas históricas institucionalizantes e promover um cuidado efetivo, integrado às vivências e demandas cotidianas das crianças, discute-se a urgência do envolvimento de todos a quem essa questão interessa para encontrar soluções dignas diante da gravidade do problema em pauta.

Instrumentos de avaliação sobre qualidade de vida em adultos estomizados: protocolo de revisão sistemática / Instruments to assess quality of life in ostomized adults: a systematic review protocol

OBJETIVO: Analisar metodologicamente resultados de pesquisas que investigaram as propriedades psicométricas(confiabilidade, responsividade e validade) de instrumentos de qualidade de vida para pessoas com estomias de eliminação. MÉTODO: Revisão sistemática da literatura que será realizada de acordo com a iniciativa Consensus-based Standards for the selection oh health Measurement INstruments (COSMIN), desenvolvida em dez etapas. As buscas serão realizadas em bases de dados nacionais e internacionais, sem restrição de idiomas e temporal. Para avaliar a qualidade metodológica dos estudos, empregar-se-á o checklist de risco de viés COSMIN, aplicando-se os critérios de qualidade para boas propriedades de medida. Por último, as evidências serão compiladas, avaliando-se sua qualidade através da abordagem GRADE. Este estudo encontra-se em andamento e o protocolo está registrado na International Prospective Register of Systematic Reviews (PROSPERO) sob o número CRD42022320642

OBJECTIVE: To methodologically analyze the results of research studies that investigated psychometric properties (reliability, responsiveness and validity) of quality of life instruments for individuals with elimination ostomies. METHOD: A systematic literature review that will be conducted according to the Consensus-based Standards for selecting health Measurement Instruments (COSMIN) initiative, developed in ten stages. The searches will be conducted in national and international databases, with no language or time restrictions. To assess the methodological quality of the studies, the COSMIN risk of bias checklist will be employed by applying the quality criteria for good measuring properties. Finally, the diverse evidence will be compiled by assessing its quality through the GRADE approach. This study is ongoing and its protocol is registered at the International Prospective Register of Systematic Reviews (PROSPERO) under number CRD42022320642

A saúde mental das crianças durante a pandemia da COVID-19: uma perspectiva de professores de uma Unidade de Educação Infantil / Children's health during the COVID-19 pandemic: a perspective from teachers at an Early Childhood Education Unit

Resumo Introdução Estudos têm alertado para os prejuízos da COVID-19 na vida de crianças e adolescentes nos âmbitos do aprendizado, relações sociais e saúde mental, assim como no desenvolvimento de modo geral. Objetivos Compreender a percepção dos professores sobre as implicações da pandemia da COVID-19 na saúde mental de crianças de uma Unidade de Educação Infantil. Método Trata-se de um estudo exploratório, descritivo de abordagem qualitativa. Foram participantes seis professores de uma Unidade de Educação Infantil pública. Os dados foram coletados remotamente utilizando-se formulários de caracterização do participante e entrevistas semiestruturadas e posteriormente investigados por meio de análise temática e do referencial teórico-metodológico da saúde mental e atenção psicossocial. Resultados Os resultados apontaram uma compreensão ampliada dos professores sobre saúde mental, envolvendo aspectos para além do quadro clínico e sintomas. Além disso, a partir da percepção dos professores, a escola pode adotar estratégias para promover a saúde mental das crianças e apoiar seus familiares em um cenário de inúmeras adversidades e dificuldades, que causaram uma série de prejuízos à saúde mental e ao desenvolvimento dessa população. Conclusão Espera-se que este estudo possa contribuir não só para a compreensão de uma realidade nova e emergente, que está sendo reinventada dia após dia, mas também para novas reflexões e discussões acerca das estratégias de intervenção e políticas públicas voltadas à saúde mental de crianças.

Abstract Introduction Studies have warned about the damages caused by COVID-19 on the lives of children and adolescents in terms of learning, social relationships, and mental health, as well as on their overall development. Objectives To understand the teachers' perceptions of the implications of the COVID-19 pandemic on the mental health of children at an Early Childhood Education Unit. Method This is an exploratory, descriptive study with a qualitative approach. Six teachers from a public Early Childhood Education Unit participated in the study. Data were collected remotely using participant characterization forms and semi-structured interviews, and then characterized through thematic analysis and the theoretical-methodological framework of mental health and psychosocial care. Results The results showed an expanded understanding by teachers about mental health, involving aspects beyond the clinical condition and symptoms. In addition, from the teachers' perceptions, the school can adopt strategies to promote the children's mental health and support their families in a scenario full of adversities and difficulties, which have caused a series of damages to the mental health and development of this population. Conclusion It is expected that this study can contribute not only to the understanding of a new and emerging reality that is being reinvented day after day but also to new reflections and discussions about intervention strategies and public policies aimed at children's mental health.

A vivência cotidiana das crianças durante a pandemia da Covid-19 / The daily experience of the Covid-19 pandemic in children's perspective

Resumo Introdução O cenário da pandemia da Covid-19 impactou significativamente a vida das pessoas, de forma que as crianças foram um dos grupos sociais mais afetados. Objetivo Compreender como as crianças vivenciaram o cotidiano na pandemia da Covid-19, a partir de sua própria perspectiva. Método Estudo exploratório, de abordagem qualitativa, realizado com 19 crianças de 9 a 11 anos, vinculadas a uma escola pública. Para a coleta de dados, foi utilizada a elucidação gráfica como disparador da temática e uma entrevista semiestruturada. Os dados produzidos foram analisados com base na análise temática. Resultados Quatro temas emergiram: a compreensão das crianças sobre a Covid-19 e os sentimentos gerados; a morte e o luto em decorrência da pandemia; as relações familiares; e a vulnerabilidade social vivenciada pelas famílias. Os resultados evidenciaram a clareza das crianças sobre a origem do vírus e sua propagação, os riscos advindos da contaminação e a importância da vacina. Em algumas famílias foi possível compartilhar mais momentos juntos e, em outras, houve o distanciamento, conflitos e relatos de violência. O desemprego e a fome também se fizeram presentes. Conclusão Os resultados permitiram identificar como as crianças vivenciaram a pandemia em um cenário de maior vulnerabilidade social, a partir das vozes e perspectivas das próprias crianças. Compreende-se que o investimento em estudos dessa natureza possibilita o melhor enfrentamento de situações futuras adversas, favorecendo o seu desenvolvimento e saúde mental, com base na proposição de políticas públicas e estratégias de cuidado a essa população.

Abstract Introduction The Covid-19 pandemic has significantly impacted people's lives, with children being one of the most affected social groups. Objective To understand how children experienced daily life during the Covid-19 pandemic from their own perspective. Method Exploratory study, using a qualitative approach, conducted with 19 children aged 9 to 11 years old, linked to a public school. Graphic elucidation was used as a trigger for the theme's collection of data, followed by a semi-structured interview. Both the narratives derived from graphic elucidations and the data produced in interviews were analyzed using content analysis. Results Some themes emerged, four of which will be presented - children's understanding of Covid-19 and the feelings generated; death and mourning as a result of the pandemic; family relationships; the social vulnerability experienced by families. The results showed how clear the children were about the origin of the virus and its spread, the risks arising from contamination such as the death of family members, and the importance of the vaccine. In some families it was possible to share more moments together and, in others, there was distancing, conflicts and reports of violence. In addition, the situation of social vulnerability stands out, in the face of unemployment and hunger. Conclusion The results made it possible to identify how children experienced the pandemic in a scenario of greater social vulnerability, based on the voices and perspectives of the children themselves. It is understood that investing in studies of this nature enables better coping with future adverse situations, favoring their development and mental health, based on the proposition of public policies and care strategies for this population.

Assistência de enfermagem com gerenciamento de caso: aumento da satisfação de pacientes com doença de Crohn / Nursing care with case management: increasing satisfaction of patients with Crohn's disease

Objetivo: Avaliar a satisfação da assistência de enfermagem sob a ótica de pacientes com Crohn atendidos pelo programa de gerenciamento de caso.Métodos: Estudo quase experimental com grupo único, do tipo antes e depois, realizado com 36 pacientes comdoença de Crohn, no período de maio a setembro de 2017 no ambulatório de gastroenterologia do hospital Universitário do Piauí. Utilizou-se a SERVQUAL adaptada para avaliar a satisfação antes e após a intervenção de programa de gerenciamento de caso, que se caracteriza como programa de cuidado paraavaliar, gerenciar, ofertarplano de cuidado e monitoraros pacientes por um período de seis meses.Resultados: OGap (lacuna) total, que é a diferença entre a expectativa com o serviço prestadoe a sua percepção, assumiu valorpositivo (0,20±0,9). As percepções dos pacientes de Crohn superaram as expectativas, isto é, os pacientes se consideraramsatisfeitos com a qualidade do serviço de enfermagem após intervenção nas dimensões confiabilidade(0,3 ± 1,3), atendimento (0,2 ± 1,1)e empatia (0,5 ± 1,5), encontrando-se,porém insatisfeitos com a segurança (-0,1±1,0).Conclusão: Houve aumento da satisfação dos pacientes com doença de Crohn após intervençãono que se refere àconfiabilidade, atendimento eempatiaoferecidadurante o programa de gerenciamento de caso

Objective: To evaluate the satisfaction of nursing care from the perspective of patients with Crohn's disease attendedby the case management program.Methods: Aquasi-experimental study with a single group, before and after, was conducted with 36 Crohn's patients,in the period from May to September 2017 in the gastroenterology outpatient clinic of the University Hospital of Piauí. The adapted SERVQUAL was used to assess satisfaction before and after the Case Management program intervention, which is characterized as a care program to assess, manage, offer care plans, and monitor patients over a six-month period.Results: The total Gap, which is the difference between the expectation ofthe service provided and its perception, assumed a positive value (0.20.2±0.9). The perceptions of Crohn's patients exceeded expectations, that is, they were satisfied with the quality of nursing service after intervention in the dimensions:reliability (0.3 ± 1.3), attendance(0.2 ± 1.1),and empathy (0.5 ± 1.5);but dissatisfied with safety (-0.1 ± 1.0).Conclusion: There was an increase in Crohn's disease patients' satisfaction after intervention regarding the reliability, attendance, and empathy offered during the case management program

Doenças ocupacionais em profissionais de um polo gesseiro: estudo transversal / Occupational diseases in professionals from a plaster production complex: a cross-sectional study / Enfermedades laborales en profesionales de un complejo de proucción de yeso: estudio transversal

RESUMO Objetivo: conhecer as doenças e sintomas ocupacionais prevalentes dos trabalhadores de um polo gesseiro. Método: trata-se de uma pesquisa de corte transversal, realizada com 67 trabalhadores de uma indústria de gesso na cidade de Grajaú, Maranhão, Brasil. Para coleta de dados, foi utilizado um questionário semiestruturado com perguntas abertas e fechadas. Os dados foram analisados por meio dos procedimentos usuais da estatística descritiva. Resultados: a amostra foi constituída por 67 trabalhadores, sendo 63 do sexo masculino (94%). Os trabalhadores que apresentaram doença relacionada ao trabalho corresponderam a seis (9%) da amostra. Os sintomas que prevaleceram foram: irritação nos olhos; irritação na pele; dores nas articulações; irritação na mucosa nasal; e problemas respiratórios. Conclusão: esses resultados apontam indicadores que podem ser utilizados como parâmetro para subsidiar a tomada de decisão quanto a políticas públicas direcionadas à saúde dos trabalhadores no contexto da mineração do gesso.

ABSTRACT Objective: to know the prevalent occupational diseases and symptoms in workers from a plaster production complex. Method: this is a cross-sectional study conducted with 67 workers of a plaster factory from the city of Grajaú, Maranhão, Brazil. A semi-structured questionnaire with open and closed questions was used for data collection. The data were analyzed by means of the descriptive statistics usual procedures. Results: the sample consisted of 67 workers, of which 63 were male (94%). Six (9%) workers from the sample presented work-related diseases. The predominant symptoms were the following: irritation in the eyes; irritation on the skin; pain in the joints; irritation in the nasal mucosa; and respiratory problems. Conclusion: these results point to indicators that can be used as a parameter to support decision-making regarding public policies aimed at workers' health in the context of gypsum mining.

RESUMEN Objetivo: conocer las enfermedades y los síntomas ocupacionales prevalentes de los trabajadores de un complejo de producción de yeso. Método: investigación de corte transversal realizada con 67 trabajadores de una fábrica de yeso de la ciudad de Grajaú, Maranhão, Brasil. Para recolectar los datos se utilizó un cuestionario semiestructurado con preguntas abiertas y cerradas. Los datos se analizaron por medio de los procedimientos habituales de la estadística descriptiva. Resultados: la muestra estuvo compuesta por 67 trabajadores, de los cuales 63 eran del sexo masculino (94%). Seis (9%) de los trabajadores de la muestra presentaron enfermedades relacionadas con el trabajo. Los síntomas que prevalecieron fueron los siguientes: irritación en los ojos, irritación en la piel, dolores en las articulaciones, irritación en la mucosa nasal y problemas respiratorios. Conclusión: estos resultados apuntan a indicadores que pueden utilizarse como parámetro para sustentar el proceso de toma de decisiones sobre políticas públicas dirigidas a la salud laboral en el contexto de la minería de yeso.

Associação entre comprometimento pulmonar, fatores de risco e desfechos em pacientes com covid-19 atendidos em hospital de referência na Paraíba / Association between lung involvement, risk factors and outcomes in COVID-19 patients treated at a reference hospital in Paraíba

Objetivo: Avaliar a associação entre o grau de comprometimento pulmonar (CP) na TC de tórax dos pacientes com COVID-19 com fatores de risco e desfechos. Métodos: Estudo observacional e retrospectivo com 284 pacientes com COVID-19. Avaliou-se idade, sexo, quadro clínico, saturação na admissão, fatores de risco, tempo de sinto-mas, porcentagem de CP, tempo de internação em enfermaria, UTI e de IOT, e óbito. Foram divididos três grupos conforme o grau de CP. Resultados: 167 pacientes possuíam comprometimento <25%; 80, 25-50%; e 37, >50%. O grupo com maior comprometimento pulmonar possuía maior idade, mais homens e maior presença de tosse, dispneia e alguma comorbidade. Também apresentou menor saturação à admissão, maior necessidade de IOT, in-ternação em enfermaria ou UTI e maior mortalidade. O CP, IOT e idade foram fatores preditores de mortalidade.Conclusões: O grau de CP aparenta estar significativamente associado a alguns parâmetros clínicos, necessidade de internação, intubação e óbito (AU)

Objective: To assess the association between the degree of lung involvement (LI) on chest CT scans of COVID-19 patients, risk factors and outcomes. Methods: Observational and retrospective study of 284 COVID-19 patients. Age, sex, clinical presentation, oxygen saturation on admission, risk factors, time after symptom onset, percentage of LI, length of stay in ward and ICU, duration of ETI, and death were assessed. 3 groups were created according to the LI. Results: 167 patients had an involvement of <25%; 80, 25-50%; and 37, >50%. The group with gre-ater LI was older, had more males and a higher incidence of cough, dyspnea and some comorbidity. Moreover, the group with greater LI had lower saturation on admission, more ETI, more admissions to the ward or ICU, and higher mortality. LI, ETI and age were predictors of mortality. Conclusion: The degree of LI appears to be significantly associated with some clinical parameters, need for hospitalization, intubation, and death (AU)

Estrutura, perfil dos frequentadores e padrão de utilização de Academias a Céu Aberto em Belo Horizonte, Minas Gerais / Characteristics, the profile of users, and pattern of use of outdoors gyms in Belo Horizonte, Minas Gerais

O objetivo deste estudo foi descrever a estrutura, o perfil dos frequentadores e o padrão de utilização de Academias a Céu Aberto (ACA) localizadas em áreas de vulnerabilidade distintas de Belo Horizonte, Minas Gerais. Estudo com delineamento transversal e análises exploratórias, realizado em duas ACA no ano de 2016. Foram utilizadas três abordagens in loco para mensurar as variáveis de interesse: das estruturas das ACA (PA R A), entrevistas face-a-face com os usuários presentes e observação sistemática dos frequentadores (SOPARC). Os dados foram analisados com a estatística descritiva e testes de qui-quadrado e Fisher no software R (p < 0,05). ACA-médio risco apresentou melhores estruturas para exercícios, conforto para usuários e condições de limpeza, estética e segurança comparadas à ACA-baixo risco. Foram entrevistados 49 adultos (51,2% mulheres) e observados 294 frequentadores (59,9% homens). Entre os usuários entrevistados, a maioria tinha mais de 50 anos, apresentavam sobrepeso ou obesidade (65,2%). Ademais, 51,0% dos entrevistados realizavam 150 minutos ou mais de atividade física moderada ou vigorosa, sendo que 24,5% deles atingiram esse tempo utilizando apenas as ACA (p = 0,016). Por meio do SOPARC, foi observado proporcionalmente maior presença de adultos (62,0%), de frequentadores em atividades sedentárias (58,4%), seguido de exercícios nos aparelhos das ACA (34,7%), e em dias de semana (64,0%). Proporção significativa de frequentadores em atividades sedentárias foi observada na ACA-baixo risco (p < 0,001). Este estudo contribui para orientação de políticas públicas de promoção de atividade física nas ACA, reforçando a relevância dos aspectos do ambiente físico e social no planejamento, monitoramento e avaliação dessas intervenções

This study aimed to describe the characteristics, the profile of users, and the pattern of use of Outdoors Gym (ACA - Portuguese abbreviation) in different socioeconomic areas of Belo Horizonte, Minas Gerais. A cross-sectional study was carried out in the two ACA in 2016. Three instruments were used to measure the variables of interest in loco: the characteristics of the ACA ( PARA), face to face interviews, and systematic observation of attendees (SOPARC). Data were analyzed using descriptive statistics and chi-square and Fisher tests in the R software (p < 0.05). ACA-medium risk showed better structures for exercises, comfort for users, and conditions of cleanliness, aesthetics, and safety compared to ACA-low risk. Forty-nine adults (51.2% women) were interviewed, and 294 participants were observed (59.9% men). Among the users in-terviewed, most were over 50 years old, were overweight or obese (65.2%). Furthermore, 51.0% of respond-ents performed 150 minutes or more of moderate or vigorous physical activity, and 24.5% of them reached this time using only the ACA (p = 0.016). Through SOPARC was observed a proportionally greater presence of adults (62.0%), who were in sedentary behaviors (58.4%), followed by ACA exercises (34.7%) and dur-ing weekdays (64.0%). A significant proportion of participants in sedentary activities was observed in the ACA-low risk (p < 0.001). This study may contribute to guiding physical activity promotion and reinforces the relevance of physical and social environments in the planning, monitoring, and evaluation of ACA

O telemonitoramento como estratégia de intervenção da terapia ocupacional com crianças e adolescentes com transtorno do espectro autista no contexto pandêmico / Telemonitoring as a strategy for the intervention of occupational therapy of children and adolescents with autistic spectrum disorders in the pandemic context

Resumo Introdução A terapia ocupacional tem atuado na perspectiva do cotidiano dos sujeitos e de seus modos de viver, tendo em vista as transformações, impactos e consequências geradas pela pandemia da COVID-19. Dentre as possibilidades de atuação do terapeuta ocupacional, tem-se o telemonitoramento. Objetivo Relatar a experiência de um projeto de extensão universitária no que tange ao telemonitoramento de crianças e adolescentes com Transtorno do Espectro Autista (TEA) e suas famílias. Método A equipe do projeto é composta por uma docente do departamento de terapia ocupacional e alunas de pós-graduação e graduação. Foi realizado um levantamento das demandas e interesses das famílias, sendo posteriormente selecionados treze crianças e dois adolescentes para as ações de telemonitoramento. Resultados As intervenções visaram à organização do cotidiano, rotina e orientação familiar. Aponta-se que o cuidado ofertado não se restringiu ao núcleo familiar, de forma que também foi realizado acompanhamento regular e apoio às equipes escolares. Conclusão O telemonitoramento possibilitou a continuidade do cuidado, promovendo o acolhimento, escuta qualificada e orientação, com base no que tem sido proposto pelas diretrizes de cuidado e políticas públicas.

Abstract Introduction Occupational Therapy has acted from the perspective of the subjects' daily lives and their ways of living, given the transformations, impacts, and consequences generated by the pandemic of COVID-19. Among the possibilities of work of the occupational therapist, there is telemonitoring. Objective To report an experience of a university extension project regarding the telemonitoring of children and adolescents with Autistic Spectrum Disorder (ASD) and their families. Method The project team is composed of a teacher from Occupational Therapy Department, and graduate and undergraduate students. A survey of the demands and interests of the families was carried out, and thirteen children and two teenagers were subsequently selected for telemonitoring actions. Results The interventions are aimed at an organization of daily life, routine, and family orientation. It is pointed out that the care offered was not restricted to the family nucleus, so regular monitoring and support for school teams were also carried out. Conclusion Telemonitoring enabled the continuity of care, as well as support for the care network, promoting a welcoming, qualified listening and guidance, based on what has been proposed by the care guidelines and public policies.

Sarcoma de Kaposi pós-transplante hepático: relato de caso / Kaposi sarcoma after liver transplantation: case report

Introdução: O sarcoma de Kaposi constitui uma neoplasia maligna multicêntrica caracterizada pelo desenvolvimento de tumores vinhosos, os quais podem ser observados tanto na pele e no tecido subcutâneo como em vísceras. O objetivo deste estudo foi relatar um caso de sarcoma de Kaposi após transplante hepático, pela raridade da ocorrência desse evento. Método: O instrumento de investigação usado para a condução deste relato foi o estudo de caso, com a coleta das informações em prontuário físico do paciente. Relato do Caso: Homem de 28 anos, com história de uso de Tacrolimus há três anos devido a transplante hepático, apresentando dor abdominal associada a diarreia, diagnosticado por meio de histopatológico de pólipo intestinal com sarcoma de Kaposi, encaminhado para tratamento quimioterápico. Considerações Finais:Pacientes receptores de transplantes de órgãos sólidos que recebem medicações imunodepressoras devem ter novos sintomas cuidadosamente investigados, para possibilitar diagnóstico neoplásico precoce. [au]

Introduction: Kaposi sarcoma is a multicentric malignant neoplasm characterized by the development of purple tumors, which can be seen both on the skin and subcutaneous tissue and on viscera. The aim of this study was to report a case of Kaposi sarcoma after liver transplantation, because of the rarity of the occurrence of this event. Method: The research instrument used to conduct this report was the case study, with the collection of information from the patient's physical record. Case Report:A 28-year-old man with a history of using Tacrolimus for three years due to liver transplantation, presenting abdominal pain associated with diarrhea, diagnosed through histopathological examination of intestinal polyp with Kaposi sarcoma, referred for chemotherapy treatment. Final Considerations: Patients who were submitted to solid organ transplants and receive immunodepressive medications should have new symptoms carefully investigated, in order to enable early diagnosis of neoplasia. [au]

A saúde mental infantojuvenil na atenção básica à saúde: da concepção às perspectivas para o cuidado / Infantile-juvenile mental health in the ABS (Basic Attention to Health): from conception to perspectives for care

Resumo Introdução A literatura aponta para um movimento recente de se avançar na compreensão de outras dimensões que perpassam pelo cuidado à saúde mental infantojuvenil, como, por exemplo, a falta de experiência, afinidade com o campo e formação profissional e a concepção da saúde mental tida pelos profissionais da saúde. Objetivo Identificar as concepções de gestores e/ou membros da equipe da Atenção Básica à Saúde sobre saúde mental infantojuvenil, assim como as suas afinidades, experiências e formação nesse campo. Método Pesquisa exploratória e descritiva, de abordagem quantiqualitativa. Participaram 53 gestores e/ou membros da equipe de Unidades de Saúde de sete municípios do Estado de São Paulo. Para a coleta de dados, foram utilizados um Formulário de Identificação e Caracterização dos Participantes e um Questionário Geral. Para a análise, utilizou-se de estatística descritiva para as informações quantitativas e os dados qualitativos foram analisados pela técnica de análise categorial. Resultados Observou-se uma concepção ampliada sobre a saúde mental infantojuvenil, de forma que, para além dos aspectos característicos do modelo médico-psiquiátrico, os participantes reconheceram os determinantes sociais e as variáveis contextuais nas concepções apresentadas. Levanta-se a hipótese de que a formação profissional, afinidade com o campo e experiências anteriores podem influenciar na concepção de saúde mental infantojuvenil adotada e no cuidado desenvolvido nos equipamentos de saúde. Conclusão Considera-se fundamental compreender melhor a saúde mental infantojuvenil no âmbito dos serviços visando refletir sobre as estratégias que favoreçam a aproximação dos profissionais da saúde com esse campo, contribuindo e qualificando o cuidado.

Abstract Introduction The literature points to a recent movement to advance in the understanding of other dimensions that permeate infantile-juvenile mental health care, such as, for example, lack of experience, affinity with the field and professional training and the conception of mental health taken by health professionals. Objective To identify the conceptions of managers and/or members of the Basic Attention to Health team on children and adolescents' mental health, as well as their affinities, experiences and training in this field. Method Exploratory and descriptive research, with a quantitative-qualitative approach. 53 managers and/or team members from Health Units from seven cities in the State of São Paulo participated. For data collection, a Participant Identification and Characterization Form, and a General Questionnaire were used. For the analysis, descriptive statistics were used for quantitative information and qualitative data were analyzed using the categorical analysis technique. Results An expanded conception of children's mental health was observed, so that, in addition to the characteristic aspects of the medical-psychiatric model, the participants recognized the social determinants and contextual variables in the concepts presented. The hypothesis raised is that professional training, affinity with the field and previous experiences can influence the adopted concept of children and adolescents' mental health as well as the care developed in health facilities. Conclusion It is considered essential to better understand infantile-juvenile mental health within the scope of services in order to reflect on strategies that favor the approximation of health professionals with this field, contributing and qualifying care.

Saúde mental e cotidiano dos estudantes de terapia ocupacional frente à Covid-19: possíveis impactos e repercussões / Mental health and everyday life of occupational therapy students facing Covid-19: possible impacts and repercussions

Resumo A presente pesquisa teve como objetivo identificar os impactos na saúde mental e no cotidiano dos estudantes do curso de graduação em terapia ocupacional de uma universidade pública federal frente ao cenário de enfrentamento da COVID-19. Trata-se de um estudo exploratório e descritivo, de abordagem quantiqualitativa. Para coleta de dados, utilizou-se um questionário semiestruturado organizado no Google Formulários®. Participaram do estudo 53 graduandos do primeiro ao último ano do curso. Os resultados apontam que 94% dos participantes são do gênero feminino, com idade entre 20 e 25 anos (78%). Antes da pandemia, os estudantes realizavam uma vasta gama de atividades semanais, sendo que 68% não apresentavam questões prévias de saúde mental ou não apresentavam dificuldades que impactavam a sua vida de forma significativa. Com o advento da pandemia e suas consequências, o estudo apontou que 94% dos participantes observaram sua saúde mental impactada e, desses, 92% sinalizaram a ansiedade como a manifestação mais recorrente. Verificou-se ainda que praticamente todas as atividades que compunham o cotidiano dos estudantes antes da pandemia da COVID-19 foram alteradas de alguma maneira, sendo a categoria socialização a segunda mais citada. Diante do cenário atual de permanência da pandemia há mais de um ano, importa investigar como e quais estratégias de enfrentamento os estudantes, mas também a população geral, têm adotado para lidar com os persistentes e permanentes desafios. Assim, aponta-se para a necessidade e importância de se investir em pesquisas que aprofundem a compreensão desses impactos e das possíveis estratégias de enfrentamento adotadas.

Abstract This research aimed to identify the impacts on mental health and the daily lives of students of the undergraduate course in Occupational Therapy at a Federal Public University in the face of the COVID-19 coping scenario. This is an exploratory and descriptive study, with a quantitative and qualitative approach. For data collection, a semi-structured questionnaire organized in Google Forms was used. Fifty-three undergraduate students from the first to the last year of the course participated in the study. The results show that 94% of the participants are female, aged between 20 and 25 years (78%). Before the pandemic, students performed a wide range of weekly activities, 68% of whom had no previous mental health issues, or had no difficulties that significantly impacted their lives. With the advent of the pandemic and its consequences, the study found that 94% of participants observed their mental health impacted, and of these, 92% showed anxiety as the most recurrent manifestation. It was also found that practically all activities that made up students' daily lives before the COVID-19 pandemic were altered in some way, with the socialization category being the second most cited. Given the current scenario, in which the pandemic has been in existence for more than a year, it is important to investigate how and which coping strategies not only students but also the general population, have adopted to deal with the persistent and permanent challenges. Thus, it points to the need and importance of investing in research that deepens the understanding of these impacts and the possible coping strategies adopted.