História da construção de saberes em enfermagem traumato-ortopédica / History of knowledge construction in trauma and orthopedic nursing care / Historia de la construcción del conocimiento en enfermería traumatológica ortopédica

Objetivo: analisar o desenvolvimento da enfermagem traumato-ortopédica a partir da primeira turma de residentes de um hospital especializado. Método: o estudo seguiu a metodologia histórica com abordagem qualitativa. As fontes foram documentos escritos e orais. Resultados: trabalhar em uma instituição especializada foi o ponto de partida para a busca por especialização de enfermeiras atuantes no cuidado traumato-ortopédico, que perceberam o saber/poder adquirido no trabalho assistencial, além da intenção de qualificar a assistência e elevar o hospital a instituto. Estratégias empregadas reúnem a busca por parcerias com instituições universitárias e associativas, além da criação de uma associação própria. Considerações finais: a enfermagem traumato-ortopédica ampliou seu espaço científico ao criar um curso de especialização com uma unidade acadêmica. Foi possível delimitar o poder acadêmico e institucional da enfermagem na instituição de saúde pela formação de enfermeiras especialistas constituindo um grupo de reconhecido pelo saber científico.

Objective: to analyze the development of trauma and orthopedic nursing care from the very first class of residents of a specialized hospital. Method: historical methodology study with a qualitative approach. The sources consisted of written and oral documents. Results: working in a specialized institution was the starting point for nurses who were seeking specialization in the field of trauma and orthopedic care as they noticed the power-knowledge acquired through care work, plus they were willing to improve assistance and take the hospital up to an institute level. Strategies used include the search for partnerships with universities and associative-type institutions, in addition to creating their own association. Final considerations: trauma and orthopedic nursing care expanded its scientific space by creating a specialization course together with an academic unit. It was possible to define the academic and institutional power of the nursing staff in the health institution by considering the training process of its nurse specialists, who consisted of a group recognized for their scientific knowledge.

Objetivo: analizar el desarrollo de la enfermería traumatológica ortopédica a partir del primer grupo de residentes de un hospital especializado. Método: estudio con metodología histórica con un enfoque cualitativo. Las fuentes fueron documentos escritos y orales. Resultados: el trabajo en una institución especializada fue el punto de partida para la búsqueda de la especialización de las enfermeras que trabajaban en la atención traumatológica ortopédica, quienes notaron el saber/poder adquirido en el trabajo asistencial, además de la intención de cualificar la atención y elevar el hospital al nivel de instituto. Las estrategias empleadas incluyen la búsqueda de alianzas con instituciones universitarias y asociaciones, y la creación de una asociación propia. Consideraciones finales: la enfermería traumatológica ortopédica amplió su espacio científico mediante la creación de un curso de especialización con una unidad académica. Se logró delimitar el poder académico e institucional de la enfermería en la institución de salud a través de la formación de enfermeros especialistas, que es un grupo reconocido por el conocimiento científico.

Hand Grip Force-Time Curve Indicators Evaluated by Dynamometer: A Systematic Review.

BACKGROUND: Handgrip strength (HGS) is an indicator of muscular strength, used in the diagnosis of sarcopenia, undernutrition, and physical frailty as well as recovery. Typically, the maximum HGS value is used; however, recent evidence suggests the exploration of new indicators provided based on the force-time curve to achieve a more comprehensive assessment of muscle function. Therefore, the objective was to identify indicators of the HGS profile beyond maximum HGS, based on force-time curves, and to systematize knowledge about their applications to various types of samples, health issues, and physical performance. METHODS: A systematic review was performed including studies whose participants' HGS was assessed with a digital or adapted dynamometer. The outcome measures were HGS profile indicators calculated from the force-time curve. RESULTS: a total of 15 studies were included, and the following indicators were identified: grip fatigue, fatigability index, fatigue rate, fatigue resistance, time to 80% maximal voluntary contraction, plateau coefficient of variability, time to maximum value, T-90%, release rate, power factor, grip work, average integrated area, endurance, cycle duration, time between cycles, maximum and minimum force-velocity, rate of grip force, final force, inflection point, integrated area, submaximal control, and response time. CONCLUSIONS: Various indicators based on the force-time curve can be assessed through digital or adapted dynamometers. Future research should analyze these indicators to understand their implications for muscle function assessment, to standardize evaluation procedures, to identify clinically relevant measures, and to clarify their implications in clinical practice.

Health Management of an HIV Testing and Counseling Center: Nursing Contributions.

OBJECTIVES: to analyze the role of nursing in the establishment of an HIV/AIDS Testing and Counseling Center in a Brazilian municipality. METHODS: a historical study utilizing primary sources, including documents and oral accounts, involving a total of ten participants. The study encompasses the years 1997 and 1998. The research took place at the Testing and Counseling Center in São João de Meriti. Data was collected from March to May 2022. RESULTS: nursing made significant contributions through the development of training initiatives led by nurses, who were also responsible for individual and group counseling, as well as HIV testing requests. FINAL CONSIDERATIONS: nursing played a crucial role in the center and in the management of Sexually Transmitted Infections, being involved in all stages of treatment in accordance with current public health policy.

The Sphinx and the egg: Evolutionary enigmas of the (glyco)sphingolipid biosynthetic pathway.

In eukaryotes, the de novo synthesis of sphingolipids (SLs) consists of multiple sequential steps which are compartmentalized between the endoplasmic reticulum and the Golgi apparatus. Studies over many decades have identified the enzymes in the pathway, their localization, topology and an array of regulatory mechanisms. However, little is known about the evolutionary forces that underly the generation of this complex pathway or of its anteome, i.e., the metabolic pathways that converge on the SL biosynthetic pathway and are essential for its activity. After briefly describing the pathway, we discuss the mechanisms by which the enzymes of the SL biosynthetic pathway are targeted to their different subcellular locations, how the pathway per se may have evolved, including its compartmentalization, and the relationship of the pathway to eukaryogenesis. We discuss the circular interdependence of the evolution of the SL pathway, and comment on whether current Darwinian evolutionary models are able to provide genuine mechanistic insight into how the pathway came into being.

Health Management of an HIV Testing and Counseling Center: Nursing Contributions / Gestión en Salud de un Centro de Pruebas y Consejería para el VIH: Contribuciones de la Enfermería / Gestão em Saúde de um Centro de Testagem e Aconselhamento de HIV: Contribuições da Enfermagem

ABSTRACT Objectives: to analyze the role of nursing in the establishment of an HIV/AIDS Testing and Counseling Center in a Brazilian municipality. Methods: a historical study utilizing primary sources, including documents and oral accounts, involving a total of ten participants. The study encompasses the years 1997 and 1998. The research took place at the Testing and Counseling Center in São João de Meriti. Data was collected from March to May 2022. Results: nursing made significant contributions through the development of training initiatives led by nurses, who were also responsible for individual and group counseling, as well as HIV testing requests. Final Considerations: nursing played a crucial role in the center and in the management of Sexually Transmitted Infections, being involved in all stages of treatment in accordance with current public health policy.

RESUMEN Objetivos: analizar la participación de la enfermería en el proceso de creación del Centro de Pruebas y Consejería para personas con VIH/Sida de un municipio brasileño. Métodos: estudio histórico con fuentes directas constituidas por documentos y fuentes orales, sumando diez participantes. El periodo abarca los años 1997 y 1998. El escenario del estudio fue el Centro de Pruebas y Consejería de São João de Meriti. Los datos se recolectaron de marzo a mayo de 2022. Resultados: la enfermería contribuyó mediante el desarrollo de acciones de capacitación por parte del enfermero, que también era responsable de las actividades de asesoramiento individual y colectivo, además de la solicitud de exámenes anti-VIH. Consideraciones Finales: la enfermería representó una categoría responsable por acciones relevantes en el centro y en el control de las Infecciones de Transmisión Sexual (ITS), estando presente en todas las etapas del tratamiento en consonancia con la política pública de salud vigente.

RESUMO Objetivos: analisar a participação da enfermagem no processo de criação do Centro de Testagem e Aconselhamento para pessoas com HIV/Aids de um município brasileiro. Métodos: estudo histórico com fontes diretas constituídas por documentos e fontes orais, totalizando dez participantes. O recorte compreende os anos de 1997 e 1998. O cenário de estudo foi o Centro de Testagem e Aconselhamento de São João de Meriti. Os dados foram coletados de março a maio de 2022. Resultados: a enfermagem contribuiu por meio do desenvolvimento de ações de capacitação pelo enfermeiro, que também era responsável pelas atividades de aconselhamento individual e coletivo, além da solicitação de exame anti-HIV. Considerações Finais: a enfermagem representou uma categoria responsável por ações relevantes no centro e no controle das Infecções Sexualmente Transmissíveis, estando presente em todas as etapas do tratamento em consonância com a política pública de saúde vigente.

Cuidados de enfermagem em terapia eletroconvulsiva no período pré-reforma psiquiátrica numa instituição brasileira / Nursing care in electroconvulsive therapy in a Brazilian institution before the Psychiatric Reform / Cuidados de enfermería en la terapia electroconvulsiva en el período prerreforma psiquiátrica en una institución brasileña

Resumo Enquadramento: A terapia electroconvulsiva (TEC) é parte do passado da enfermagem que precisa de ser conhecido, a fim de dar sentido às transformações nos saberes e práticas após a Reforma Psiquiátrica. Objetivo: Identificar os cuidados de enfermagem na aplicação da terapia electroconvulsiva em utentes internados num instituto psiquiátrico brasileiro entre 1980 e 1990. Metodologia: Investigação histórico-social em documentos escritos da instituição cenário e orais produzidos com profissionais de enfermagem, interpretados à luz do referencial foucaultiano. Resultados: Os cuidados de enfermagem foram definidos pela experiência quotidiana e realizados nos momentos pré, trans e pós a aplicação da terapia electroconvulsiva. A enfermagem não tinha formação profissional e agia por conta própria, aplicando a terapia para acalmar utentes agitados ou acompanhando a aplicação pelo médico, prestando cuidados para reduzir efeitos colaterais. Conclusão: Apesar do modelo manicomial, a aplicação da terapia electroconvulsiva contava com cuidados de enfermagem aos utentes para evitar efeitos indesejados. A enfermagem acompanhou o declínio da TEC na sociedade. Este estudo evidenciou características da TEC que não se adequam à prática contemporânea.

Abstract Background: Electroconvulsive therapy (ECT) is a part of Brazilian Nursing History that needs to be known to understand the evolution of knowledge and practice following the Psychiatric Reform. Objective: To identify nursing care for inpatients undergoing ECT at a Brazilian psychiatric institution between 1980 and 1990. Methodology: Social-historical study based on written documents from a Brazilian psychiatric institution and oral statements from nursing professionals, analyzed according to Foucault's framework. Results: Nursing care was defined based on everyday experiences and provided before, during, and after ECT. Nursing professionals had no professional training. They acted autonomously, administering ECT to calm agitated patients, or accompanied physicians' interventions, providing care to reduce the side effects of ECT. Conclusion: Despite being part of the asylum-style care model, ECT included nursing care to avoid unwanted effects. Nursing professionals witnessed the decline of ECT in society. The present study describes aspects of ECT that are inconsistent with today's practice.

Resumen Marco contextual: La terapia electroconvulsiva (TEC) forma parte del pasado de la enfermería que es necesario conocer para dar sentido a las transformaciones del conocimiento y la práctica tras la Reforma Psiquiátrica. Objetivo: Identificar los cuidados de enfermería en la aplicación de la terapia electroconvulsiva en pacientes ingresados en un instituto psiquiátrico brasileño entre 1980 y 1990. Metodología: Investigación histórico-social en documentos escritos de la institución y documentos orales producidos con profesionales de enfermería, interpretados según el referencial foucaultiano. Resultados: Los cuidados de enfermería se definieron por la experiencia diaria y se llevaron a cabo antes, durante y después de la terapia electroconvulsiva. El personal de enfermería no tenía formación profesional y actuaba por su cuenta, aplicando la terapia para calmar a los pacientes agitados o acompañando la aplicación del médico, proporcionando cuidados para reducir los efectos secundarios. Conclusión: A pesar del modelo de manicomio, la aplicación de la terapia electroconvulsiva contaba con cuidados de enfermería a los pacientes para evitar efectos no deseados. La enfermería ha seguido el declive de la TEC en la sociedad. Este estudio pone de manifiesto las características de la TEC que no se ajustan a la práctica contemporánea.

Formação da identidade profissional de enfermeiros para o trabalho no sistema prisional / Development of the professional identity of nurses to work in the prisonal system / Formación de la identidad profesional de los enfermeros para trabajar en el sistema penitenciario

Objetivo:analisar elementos motivadores da construção da identidade profissional de enfermeiros do sistema prisional. Método: estudo histórico-social, qualitativo, sob o método de triangulação de fontes orais e documentais coletados de maio a dezembro de 2020, iluminado pelo referencial foucaultiano. Protocolo de pesquisa aprovado pelo Comitê de Ética e Pesquisa da instituição signatária. Resultados: a realização de concurso público para o sistema prisional foi motivada pela aquisição de estabilidade. Os enfermeiros concursados eram despreparados para cuidar de pessoas presas. A disciplina e os poderes exercidos pelos guardas e presos surpreenderam estes enfermeiros, que precisaram se adaptar ao sistema num contexto social marcado pela violência urbana. Considerações finais: destaca-se, na construção da identidade destes profissionais, a capacidade para contornar medos e inseguranças, exercício de poder disciplinar e normatização do cuidado para o enfrentamento do cotidiano do trabalho. Emerge a necessidade de capacitação de enfermeiros nesta área na formação profissional(AU)

Objective: to analyze elements that motivate the construction of the professional identity of nurses in the prison system. Method: historical-social, qualitative study, under the method of triangulation of oral and documental sources collected from May to December 2020, illuminated by the Foucaultian reference. Approved by the Ethics and Research Committee. Results: the holding of a public tender for the prison system was motivated by the acquisition of stability. The registered nurses were unprepared to take care of prisoners. The discipline and powers exercised by guards and prisoners surprised these nurses, who had to adapt to the system in a social context marked by urban violence. Final considerations: in the construction of the identity of these professionals, the ability to overcome fears and insecurities, exercising disciplinary Power and standardizing care for coping with daily work is highlighted. The need to train nurses in thisarea in professional training emerges(AU)

Objetivo: analizar elementos que motivan la construcción de la identidad profesional de las enfermeras en el sistema penitenciario. Método: estudio histórico-social, cualitativo, iluminado por el referente foucaultiano, que utiliza el método de triangulación de fuentes orales y documentales recolectadas de mayo a 20 de diciembre. El Comité de Ética en Investigación de la institución firmante aprobó el protocolo de investigación. Resultados: la realización de un concurso público para el sistema penitenciario estuvo motivada por la adquisición de estabilidad. Los enfermeros aprobados por ese concurso público no estaban preparados para cuidar a los presos. La disciplina y los poderes que ejercían los guardias y presos sorprendieron a estos enfermeros, que debieron adaptarse al sistema en un contexto social marcado por la violencia urbana. Consideraciones finales: en la construcción de la identidad de estos profesionales se destaca la capacidad de superación de miedos e inseguridades, ejercicio de poder disciplinario y estandarización de los cuidados para hacer frente al cotidiano del trabajo. Surge la necesidad de capacitar a enfermeros en esta área en la formación profesional(AU)

Uniforme e a imagem da enfermeira formada pela Escola de Enfermeiras Rachel Haddock Lobo / Uniform and the image of the nurse graduated from the Rachel Haddock Lobo Nursing School / Uniforme e imagen de la enfermera egresada de la Escuela de Enfermería Rachel Haddock Lobo

Objetivo: analisar os efeitos simbólicos dos uniformes utilizados pelas alunas da Escola de Enfermeiras Rachel Haddock Lobo. Método: estudo histórico-social, com corpus documental constituído de fontes orais, escritas e fotográficas que retratam os uniformes, no período de 1948 a 1951, que corresponde a inauguração da escola até a formação da primeira turma. A análise dos dados fundamentou-se nos conceitos de Pierre Bourdieu. Resultados: as alunas utilizaram três tipos de uniformes: hospitalar, saúde pública e de enfermeira. Durante a formação, rituais como a recepção da touca e a diplomação institucionalizaram e solenizaram o uso do uniforme. As professoras utilizavam uniformes de sua escola de formação. Conclusão: os uniformes foram utilizados como estratégia desenvolvida pelas enfermeiras da Escola para o fortalecimento da imagem da enfermeira de alto padrão na sociedade(AU)

Objective: to analyze the symbolic effects of the uniforms worn by students at the Rachel Haddock Lobo Nursing School. Method: historical-social study, with a documentary corpus consisting of oral, written and photographic sources that portray uniforms, from 1948 to 1951, which corresponds to the inauguration of the school until the formation of the first class. Data analysis was based on Pierre Bourdieu's concepts. Results: the students wore three types of uniforms: hospital, public health and nurse. During training, rituals such as receiving the cap and receiving diplomas institutionalized and solemnized the use of the uniform. The professors wore uniforms from their training school. Conclusion: uniforms were used as a strategy developed by the School's nurses to strengthen the image of high-standard nurses in society(AU)

Objetivo: analizar los efectos simbólicos de los uniformes usados por las alumnas de la Escuela de Enfermería Rachel Haddock Lobo. Método: estudio histórico-social, con un corpus documental compuesto por fuentes orales, escritas y fotográficas que retratan uniformes, desde 1948 a 1951, que corresponde desde la inauguración del colegio hasta la formación del primer grupo. El análisis de los datos se basó en los conceptos de Pierre Bourdieu. Resultados: las alumnas usaron tres tipos de uniforme: hospitalario, de salud pública y de enfermera. Durante la formación, rituales como recibir la cofia y el diploma institucionalizaron y solemnizaron el uso del uniforme. Las profesoras usaban uniformes de su escuela de formación. Conclusión: los uniformes fueron utilizados como una estrategia desarrollada por las enfermeras de la Escuela para fortalecer la imagen de la enfermería de alto estándar en la sociedad(AU)

Landing wise program: feasibility study protocol for Parkinson's disease.

Regardless of the benefits of fall prevention programs, people with Parkinson's disease (PD) will still fall. Therefore, it is crucial to explore novel therapeutic approaches that are well-accepted and effective for addressing fall risk and the fear of falls among this population. The present study aims to assess the feasibility of the Landing Wise program as a therapeutic intervention for reducing the fear of falling in people with PD. A mixed-methods study will be conducted using convenience sampling to recruit 20 people with PD with a moderate concern of falling from a Parkinson's Patients Association. In addition to usual care, participants will attend 2 days per week, 90 min group sessions for 8 weeks. The intervention combines group cognitive behavioral intervention with the training of safe landing strategies. Feasibility will be assessed by six key domains (recruitment strategy and rates, enrollment, retention, acceptability, reasons for decline/withdrawal, and adverse events). Quantitative data will be analyzed using descriptive statistics to characterize the sample, followed by inferential statistics to evaluate differences in the Short Falls Efficacy Scale-International Scale, Movement Disorder Society Unified Parkinson's Disease Rating Scale, Timed Up Go, 6-Minutes Walking Distance, and fall frequency and severity scores between baseline and final assessment. Qualitative data will be analyzed using an inductive thematic analysis process. There is a growing interest in developing new effective therapeutic approaches for people with PD. If proven program feasibility, this study precedes a randomized controlled trial to establish the effectiveness of the Landing Wise program.

Particular issues to be considered in small field dosimetry for TrueBeam STx commissioning.

This study aims to report the relevant issues concerning small fields in the commissioning of a TrueBeam STx for photon energies of 6MV, 10MV, 6FFF, and 10FFF. Percent depth doses, profiles, and field output factors were measured according to the beam model configuration of the treatment planning system. Multiple detectors were used based on the IAEA TRS-483 protocol as well as EBT3 radiochromic film. Analytical Anisotropic and Acuros XB algorithms, were configured and validated through basic dosimetry comparisons and end-to-end clinical tests.

The fats of the matter: Lipids in prebiotic chemistry and in origin of life studies.

The unique biophysical and biochemical properties of lipids render them crucial in most models of the origin of life (OoL). Many studies have attempted to delineate the prebiotic pathways by which lipids were formed, how micelles and vesicles were generated, and how these micelles and vesicles became selectively permeable towards the chemical precursors required to initiate and support biochemistry and inheritance. Our analysis of a number of such studies highlights the extremely narrow and limited range of conditions by which an experiment is considered to have successfully modeled a role for lipids in an OoL experiment. This is in line with a recent proposal that bias is introduced into OoL studies by the extent and the kind of human intervention. It is self-evident that OoL studies can only be performed by human intervention, and we now discuss the possibility that some assumptions and simplifications inherent in such experimental approaches do not permit determination of mechanistic insight into the roles of lipids in the OoL. With these limitations in mind, we suggest that more nuanced experimental approaches than those currently pursued may be required to elucidate the generation and function of lipids, micelles and vesicles in the OoL.

Cell lipid droplet heterogeneity and altered biophysical properties induced by cell stress and metabolic imbalance.

Lipid droplets (LD) are important regulators of lipid metabolism and are implicated in several diseases. However, the mechanisms underlying the roles of LD in cell pathophysiology remain elusive. Hence, new approaches that enable better characterization of LD are essential. This study establishes that Laurdan, a widely used fluorescent probe, can be used to label, quantify, and characterize changes in cell LD properties. Using lipid mixtures containing artificial LD we show that Laurdan GP depends on LD composition. Accordingly, enrichment in cholesterol esters (CE) shifts Laurdan GP from ∼0.60 to ∼0.70. Moreover, live-cell confocal microscopy shows that cells present multiple LD populations with distinctive biophysical features. The hydrophobicity and fraction of each LD population are cell type dependent and change differently in response to nutrient imbalance, cell density, and upon inhibition of LD biogenesis. The results show that cellular stress caused by increased cell density and nutrient overload increased the number of LD and their hydrophobicity and contributed to the formation of LD with very high GP values, likely enriched in CE. In contrast, nutrient deprivation was accompanied by decreased LD hydrophobicity and alterations in cell plasma membrane properties. In addition, we show that cancer cells present highly hydrophobic LD, compatible with a CE enrichment of these organelles. The distinct biophysical properties of LD contribute to the diversity of these organelles, suggesting that the specific alterations in their properties might be one of the mechanisms triggering LD pathophysiological actions and/or be related to the different mechanisms underlying LD metabolism.

Tank color influences the response of tomato clownfish (Amphiprion frenatus) to an acute stress challenge.

The trade of aquarium organisms is growing worldwide. This market depends on a continuous supply of healthy and colorful aquatic animals, but this sector has few initiatives. However, in the last decade, there has been a growing interest in researching captive breeding of these animals, aiming to develop a more sustainable aquarium hobby. Larviculture is an important phase in the cultivation process because the larvae are more sensitive to stress and variations in the bulk of variables, such as temperature, salinity, nutritional management, light intensity and spectrum, and environmental background colors. Because background color could be a promoter variable of proper welfare, we tested whether it affects the endocrine response of tomato clownfish Amphiprion frenatus larvae to an acute stress challenge. We show that background color influences the endocrine stress axis responsiveness in tomato clownfish. When fish were subjected to a standard acute stressor of 61 days after hatching, only fish adapted to white walls increased the whole-body cortisol levels. From the results presented herein, we recommend that white tanks be avoided for A. frenatus larviculture. Both, the less stress level and the good welfare condition of larvae reared in colored tanks may have robust, practical applications since almost all clownfish in the ornamental aquarium trade come from captive breeding.

O sintoma da criança: a criança como sintoma dos pais / Le symptôme de l'enfant: l'enfant comme symptôme des parents / The symptom of the child: the child as a symptom of the parents

A questão que introduz este artigo diz respeito à constituição do sintoma da criança e como este é atravessado pelo discurso dos pais. Na bagagem adquirida na clínica foi possível observar como as manifestações do inconsciente aparecem nos detalhes no discurso do indivíduo. Tem-se como intuito marcar a importância das funções paterna e materna na constituição da criança e, quando essas não operam, a desordem que podem causar no psiquismo infantil. Busca-se sensibilizar a noção de que a desorganização psíquica dos pais tem repercussão no processo de subjetivação dos filhos. Nota-se a impossibilidade de separar a criança dos pais no processo analítico, uma vez que ela ainda não se diferenciou enquanto sujeito. Convém não desconsiderar a resposta da criança. Há algo que é dela, que diz respeito à sua singularidade e que não podemos deixar de lado. A função parental tem como responsabilidade a imposição de limites, a orientação para a lógica da hierarquia, e não do igualitarismo, em que pai e filho têm os mesmos direitos e deveres. Entretanto, lidamos hoje com uma sociedade que desacredita da potência desse aparelho regulador e, por consequência, podemos observar um excesso de gozo. O que se colhe disso são crianças que têm que lidar com a falta da falta que a castração impõe a todos

La question qui introduit cet article concerrne la constitution du symptôme de l'enfant et comme elle est traversée par le discours des parents. Avec l'expérience acquise en clinique, cela a été possible d'observer comment les manifestations de l'inconscient apparaissent dans les détails du discours de l'individu. Il a l'intention de souligner l'importance des fonctions paternelle et maternelle dans la constitution de l'enfant et quand celles-ci n'opèrent pas, elles peuvent causer le désordre dans le psychisme infantile. Nous cherchons à sensibiliser la notion que la désorganisation psychique des parents a une répercussion dans le procès de subjectivation des fils. On peut noter l'impossibilité de séparer l'enfant des parents dans le procès analytique, une fois qu'il ne s'est pas différencié en tant que sujet. Il convient de déconsidérer que la réponse de l'enfant. Il y a quelque chose qui est à lui, qui concerne sa singularité et que nous pouvons laisser de côté. Cependant, nous faisons face aujourd'hui à une société qui ne croit pas à la puissance de cet appareil régulateur et, par conséquence, nous pouvons observer un excès de jouissance. Ce que nous en recueillons ce sont des enfants qui doivent gérer avec le manque du manque que la castration impose à tous.

The question that introduces this article concerns the constitution of the child's symptom and how it is traversed by the discourse of the parents. In the baggage acquired through clinical practice, it was possible to observe how manifestations of the unconscious appear in the details of the individual's speech. The aim is to emphasize the importance of both paternal and maternal functions in the constitution of the child, and when these functions do not operate, the disorder they can cause in the child's psyche. The intention is to raise awareness of the notion that the psychic disorganization of the parents has repercussions on the process of subjectivation of the children. It is noted the impossibility to separate the child from the parents in the analytic process, as the child has not yet differentiated itself as a subject. It is worth not disregarding the child's response. There is something that belongs to the child, related to their uniqueness, that we cannot overlook. The parental function bears the responsibility of imposing limits, guiding towards the logic of hierarchy, rather than egalitarianism, where the parent and the child have the same rights and duties. However, today we deal with a society that disbelieves in the potency of this regulatory apparatus, and consequently, we can observe an excess of jouissance. What is gathered from this is that we have children who must cope with the lack of absence that castration imposeson everyone

Discursividades pós-modernas: leitura do fenômeno social da polarização / Une lecture du phénomène social de polarisation par l'analyse des discours postmodernes / Postmodern discourses: reading the social phenomenon of polarization

O crescimento da discursividade social acerca de fenômenos como o feminicídio, a violência machista, racista, homofóbica e religiosa, além da hostilidade crescente de alguns grupos identitários ao valores conservadores da sociedade ocidental judaico-cristã, indicam que uma cultura do ódio floresceu no laço social polarizado. Os afetos de amor e ódio se apresentam no início da constituição do sujeito em estado de desligamento, mas se fundem quando prevalece o amor do Outro primordial ao infante desamparado. É a hegemonia do amor que promove a fusão pulsional. Se a civilização triunfa, se o Outro primordial alcança impor o predomínio do amor sobre o ódio, o sujeito se constitui graças ao recalque dos impulsos destrutivos e se torna capaz de alimentar a esperança no futuro, amar e trabalhar. Os afetos são o que existe de mais real na relação dos seres falantes ao Outro. Seja para amá-lo, seja para odiá-lo, seja para ignorá-lo, a existência do Outro simbólico é, para cada um, uma dimensão real em jogo no laço social. O Outro da modernidade é liberal, progressista e acredita que a igualdade de oportunidades cresce com o acesso universal à educação e à saúde. E o Outro da nossa pós-modernidade? É fragmentado, não há referências coletivas universais? É pessimista ou a esperança utópica se tornou inimiga darealidade?

La croissance de la discursivité sociale sur des phénomènes tels que le féminicide, la violence sexiste, raciste, homophobe et religieuse, en plus de l'hostilité croissante de certains groupes identitaires aux valeurs conservatrices de la société occidentale judéo-chrétienne, indiquent qu'une culture de la haine s'est diffusée dans le lien social polarisé. Les affects d'amour et de haine apparaissent au début de la constitution du sujet dans un état de détachement, mais se confondent lorsque l'amour de l'Autre primordial pour l'enfant sans défense l'emporte. C'est l'hégémonie de l'amour qui favorise la fusion pulsionnelle. Si la civilisation triomphe, si l'Autre primordial parvient à imposer la prédominance de l'amour sur la haine, le sujet se constitue grâce au refoulement des pulsions destructrices et devient capable de nourrir l'espoir en l'avenir, d'aimer et de travailler. Les affects sont ce qu'il y a de plus réel dans la relation entre les êtres parlants et l'Autre. Qu'on l'aime, qu'on le déteste ou qu'on l'ignore, l'existence de l'Autre symbolique est, pour chacun, une véritable dimension en jeu dans le lien social. L'Autre de la modernité est libéral, progressiste et croit que l'égalité des chances augmente avec l'accès universel à l'éducation et à la santé. Et qu'en est-il de l'Autre de notre postmodernité? Est-il fragmenté, n'y a-t-il pas de références collectives universelles? Est-il pessimiste? L'espoir utopique est-il devenu l'ennemi de la réalité?

The growth of social discursivity about phenomena such as feminicide, sexist, racist, homophobic and religious violence, in addition to the growing hostility of some identity groups towards the conservative values of Western Christian culture, indicate that a culture of hate has flourished in a progressively polarized social bond. The affections of love and hate appear at the beginning of the constitution of the subject in a state of detachment, but merge when the love of the primordial Other for the helpless infant prevails. It is the hegemony of love that promotes the fusion of the drive. If civilization triumphs, if the primordial Other manages to impose the predominance of love over hate, the subject is constituted thanks to the repression of destructive impulses and becomes capable of nourishing hope in the future, through love and work. Affections are what is most real in the relationship between talking beings and the Other. Whether to love it, to hate it, or to ignore it, the existence of the symbolic Other is, for each one, a real dimension at play in the social bond. The Other of modernity is liberal, progressive and believes that equal opportunities grow with universal access to education and health. What to say of the Other of our postmodernity? Is it fragmented, are there no universal collective references? Is it pessimistic? Has utopian hope become the enemy of reality?

Iodine intake assessment in the staff of a Porto region university (Portugal): the iMC Salt trial.

PURPOSE: Iodine deficiency disorder (IDD) is an ongoing worldwide recognized problem with over two billion individuals having insufficient iodine intake. School-aged children and pregnant women are often target groups for epidemiological studies, but there is a lack of knowledge on the general adult population. The aim of this study was to assess the iodine status among a Portuguese public university staff as a proxy for the adult working population. METHODS: The population study covered 103 adults within the iMC Salt randomized clinical trial, aged 24-69 years. Urinary iodine concentration was measured spectrophotometrically using the Sandell-Kolthoff reaction. Iodine food intake was assessed using a 24-h dietary recall. The contribution of discretionary salt to the iodine daily intake was assessed through 24-h urinary sodium excretion (UIE) and potentiometric iodine determination of household salt. RESULTS: The mean urine volume in 24 h was 1.5 L. The median daily iodine intake estimated from 24-h UIE was 113 µg/day, being lower among women (p < 0.05). Only 22% of participants showed iodine intake above the WHO-recommended cutoff (150 µg/day). The median daily iodine intake estimated from the 24-h dietary recall was 58 µg/day (51 and 68 µg/day in women and men, respectively). Dairy, including yoghurt and milk products, were the primary dietary iodine source (55%). Iodine intake estimated from 24-h UIE and 24-h dietary recall was moderately correlated (Spearman rank correlation coefficient r = 0.34, p < 0.05). The average iodine concentration in household salt was 14 mg I/kg, with 45% of the samples below the minimum threshold preconized by WHO (15 mg I/kg). The contribution of discretionary salt to the daily iodine intake was around 38%. CONCLUSION: This study contributes new knowledge about iodine status in Portuguese working adults. The results revealed moderate iodine deficiency, particularly in women. Public health strategies and monitoring programs are needed to ensure iodine adequacy in all population groups.

Organizational politics and professional struggles in nursing.

OBJECTIVE: to analyze the professional struggles between nursing organizational entities, in Rio de Janeiro, during the Regional Nursing Council's electoral process (1990-1993 administration). METHOD: historical study. We used journalistic articles, normative documents, legislation and semi-structured interviews with five nursing professionals who participated in this process. Interpretation of findings was supported by Bourdieu's concepts of habitus, field, capital, and symbolic power. RESULTS: Electoral Code changes of the aforementioned council, under the influence of administration (1987-1990), candidate for re-election, influenced the disclosure and eligibility criteria, making it difficult for broad participation, especially of Associação Brasileira de Enfermagem Rio de Janeiro Section. FINAL CONSIDERATIONS: nursing, in this period, generated a field of disputes related to positions of power and gender, which was evidenced in the electoral process studied, which highlighted using limiting strategies by a group, making it difficult for the entire category to participate.

All that glitters is not gold: a stereological study of human donor oocytes.

Here we report a quantitative analysis of human metaphase II (MII) oocytes from a 22-year-old oocyte donor, retrieved after ovarian-controlled hyperstimulation. Five surplus donor oocytes were processed for transmission electron microscopy (TEM), and a stereological analysis was used to quantify the distribution of organelles, using the point-counting technique with an adequate stereological grid. Comparisons between means of the relative volumes (Vv) occupied by organelles in the three oocyte regions, cortex (C), subcortex (SC) and inner cytoplasm (IC), followed the Kruskal-Wallis test and Mann-Whitney U-test with Bonferroni correction. Life cell imaging and TEM analysis confirmed donor oocyte nuclear maturity. Results showed that the most abundant organelles were smooth endoplasmic reticulum (SER) elements (26.8%) and mitochondria (5.49%). Significant differences between oocyte regions were found for lysosomes (P = 0.003), cortical vesicles (P = 0.002) and large SER vesicles (P = 0.009). These results were quantitatively compared with previous results using prophase I (GV) and metaphase I (MI) immature oocytes. In donor MII oocytes there was a normal presence of cortical vesicles, SER tubules, SER small, medium and large vesicles, lysosomes and mitochondria. However, donor MII oocytes displayed signs of cytoplasmic immaturity, namely the presence of dictyosomes, present in GV oocytes and rare in MI oocytes, of SER very large vesicles, characteristic of GV oocytes, and the rarity of SER tubular aggregates. Results therefore indicate that the criterion of nuclear maturity used for donor oocyte selection does not always correspond to cytoplasmic maturity, which can partially explain implantation failures with the use of donor oocytes.

La importancia de la vacunación frente al rotavirus / The importance of vaccination against rotavirus

A lo largo de los años hay dos medidas que han tenido un extraordinario impacto positivo en la salud de los ciudadanos del mundo: la potabilización del agua y la vacunación. El rotavirus (RV), cuya transmisión es por vía oral, está presente en todos los países y en los distintos continentes. Su afectación produce daño sistémico, aunque es el aparato digestivo de los niños menores de 2 años el más afectado. Los cuadros de diarrea y fiebre alta ocasionan del 14 al 30% de todos los casos de gastroenteritis aguda (GEA), requiriendo hospitalización aproximadamente una cuarta parte de ellos. También conlleva un elevado uso de los recursos sanitarios, pérdida de horas laborales y gran angustia y preocupación para los familiares. Con la utilización de las vacunas se han disminuido en un 60-80% los ingresos por gastroenteritis aguda por rotavirus (GEA-RV) y un 30-40% la mortalidad por diarrea en menores de 5 años. En España se dispone de dos vacunas, financiada para los prematuros nacidos entre las 25 y las 32 semanas. Ambas vacunas solo tienen sentido utilizarlas en las primeras semanas de vida, con ciertas diferencias entre ellas, tanto en el número de dosis como en la consecución de la máxima protección.(AU)

Two measures have had an extraordinarily positive impact on the health of world citizens over the years: water potabilization and vaccination. Rotavirus (RV), which has oral transmission, is present in all countries and different continents. It causes systemic damage, although the digestive system of <2-year-old children is the most affected. Diarrhea and high temperature cause from 14 to 30% of all cases of acute gastroenteritis (AGE), and one fourth of these will require hospitalization. This also entails a high use of health resources, work hours missed, and high anxiety and concern among relatives. The use of vaccines has reduced by 60-80% the hospital admissions due to acute gastroenteritis caused by rotavirus (RV-AGE) and by 30-40% the mortality by diarrhea in <5-year-olds. There are two vaccines available in Spain, only reimbursed for pre-term children born between 25 and 32 weeks of pregnancy. It only makes sense to use these vaccines during the first weeks of life, with certain differences between them in number of doses and in the achievement of maximum protection.(AU)