Individual differences in numerical representations of risk in health decision making: A fuzzy-trace theory approach.

Fuzzy-trace theory predicts that decisionmakers process numerical information about risk at multiple levels in parallel: the simplest level, nominal (categorical some-none) gist, and at more fine-grained levels, involving relative comparison (ordinal less-more gist) and exact quantities (verbatim representations). However, little is known about how individual differences in these numerical representations relate to judgments and decisions, especially involving health tradeoffs and relative risks. To investigate these differences, we administered measures of categorical and ordinal gist representations of number, objective numeracy, and intelligence in two studies (Ns = 978 and 956). In both studies, categorical and ordinal gist representations of number predicted risk judgments and decisions beyond objective numeracy and intelligence. Participants with higher scores in categorical gist were more likely to choose options to avoid cancer recurrence risks; those who were higher in ordinal gist of numbers were more likely to discriminate relative risk of skin cancer; and those with higher scores in objective numeracy were more likely to choose options that were numerically superior overall in terms of relative risk of skin cancer and of genetic risks of breast cancer (e.g., lower numerical probability of cancer). Results support parallel-processing models that assume multiple representations of numerical information about risk, which vary in precision, and illustrate how individual differences in numerical representations are relevant to tradeoffs and risk comparisons in health decisions. These representations cannot be reduced to one another and explain psychological variations in risk processing that go beyond low versus high levels of objective numeracy.

Saúde mental e qualidade de vida da família na luta contra o câncer infantojuvenil / Mental health and quality of life of the family in fighting childhood and adolescent cancer

O número de crianças e adolescentes com câncer ao redor do mundo aumenta a cada ano, afe-tando diretamente a qualidade de vida do paciente e da família. O objetivo do presente estudo foi compreender a relação entre sofrimento psicológico e qualidade de vida dos pais e cuidado-res. Participaram do estudo 21 mães de crianças ou adolescentes que estão em tratamento de câncer, que responderam online questões sobre a histórica clínicados filhos, o Questionário Pediátrico de Qualidade de Vida 4.0 e a Escala de Depressão, Ansiedade, e Estresse -Versão Reduzida. Os resultados indicaram que quanto mais as crianças ou adolescentes apresentavam problemas sobre Aspetos Emocionais e Atividades Escolares da qualidade de vida, mais as mães sentiam sintomas de ansiedade e estresse. Este estudo vem demonstrar a importância de pro-mover saúde mental das famílias, especialmente das mães, que geralmente assumem sozinhas o papel de lidar com as demandas do tratamento. (AU)

The number of children and adolescents with cancer increases every year around the world, directly affecting the quality of life of the patient and their family. The aim of the present study was to understand the connection between psychological distress and quality of life of parents and caregivers. Twenty-one mothers of children or adolescents who are undergoing cancer treatment participated in the study, who answered online questions about the clinical history of their offspring, the Pediatric Quality of Life Questionnaire 4.0 and the Depression, Anxiety and Stress Scale -Short Version. The results indicated that the more the children or adolescents presented quality of life’s problems about Emotional Aspects and School Activi-ties, the more mothers felt symptoms of anxiety and stress. This study has demonstrated the importance of promoting the mental health of families, especially mothers, who usually deal with the demands of treatment alone. (AU)

Preliminary results of a Cognitive-Behavioral Life Skills Program for Adolescents / Resultados preliminares do Programa Cognitivo-Comportamental de Habilidades para Vida em Adolescentes / Resultados preliminares de Programa Cognitivo-Conductual de Habilidades para la Vida en Adolescentes

The aim of this study was to evaluate the effect of the Life Skills Promotion Program in Adolescents (PRHAVIDA-Adolescents) on the development of a repertoire of life skills based on the cognitive-behavioral approach. A study was carried out with 78 adolescents (M = 12.47 years; SD = 0.69) to compare the results of the Social Skills Inventory for Adolescents (IHSA-Del-Prette) before and after the intervention. Differences were found between pre- and post-test considering the frequency of emission of skills for girls in the subscales self-control, assertiveness, affective approach, and social development; boys showed differences in the subscales empathy, self-control, assertiveness, affective approach, and social development. Thus, it is considered that PRHAVIDA-Adolescents is an effective program that has demonstrated that it is capable of developing several relevant skills for both sexes at a satisfactory level. Its contents proved to be comprehensive, consisting of a viable alternative for health promotion for adolescents within the cognitive-behavioral approach. (AU)

O objetivo deste estudo foi a avaliação do efeito do Programa de Promoção de Habilidades para a Vida em Adolescentes (PRHAVIDA-Adolescentes) no desenvolvimento de um repertório de habilidades para a vida com base na abordagem cognitivo-comportamental. Foi realizado um estudo com 78 adolescentes (M = 12,47 anos; DP = 0,69) para comparar resultados do Inventário de Habilidades Sociais para Adolescentes (IHSA-Del-Prette) antes e depois da intervenção. Foram encontradas diferenças entre pré e pós-teste considerando a frequência de emissão das habilidades para meninas nas subescalas autocontrole, assertividade, abordagem afetiva e desenvolvimento social; já os meninos apresentaram diferença nas subescalas empatia, autocontrole, assertividade, abordagem afetiva e desenvolvimento social. Dessa forma, considera-se que o PRHAVIDA-Adolescentes é um programa efetivo que demonstrou ser capaz de desenvolver diversas habilidades relevantes para ambos os sexos em nível satisfatório. Seus conteúdos se mostraram abrangentes, consistindo em alternativa viável para a promoção de saúde para adolescentes dentro da abordagem cognitivo-comportamental. (AU)

El objetivo de este estudio fue evaluar el efecto del Programa de Promoción de Habilidades para la Vida en Adolescentes (PRHAVIDA-Adolescentes) en el desarrollo de un repertorio de habilidades para la vida basado en el enfoque cognitivo-conductual. Se realizó un estudio con 78 adolescentes (M = 12,47 años; DS = 0,69) para comparar los resultados del Inventario de Habilidades Sociales para Adolescentes (IHSA-Del-Prette) antes y después de la intervención. Se encontraron diferencias entre el pre y postest considerando la frecuencia de emisión de habilidades para las niñas en las subescalas de autocontrol, asertividad, afectividad y desarrollo social; los niños, por su parte, mostraron diferencias en las subescalas de empatía, autocontrol, asertividad, afectividad y desarrollo social. Así, se considera que PRHAVIDA-Adolescentes es un programa efectivo que ha demostrado que es capaz de desarrollar varias habilidades relevantes para ambos sexos a un nivel satisfactorio. Su contenido resultó ser integral, constituyendo una alternativa viable para la promoción de la salud de los adolescentes dentro del enfoque cognitivo-conductual. (AU)

Intenção de se vacinar contra a COVID-19 e hesitação vacinal no Sul do Brasil: prevalência e fatores associados / Intention to get vaccinated against COVID-19 and vaccine hesitation in Southern Brazil: prevalence and associated factors

INTRODUÇÃO: A vacinação contra a COVID-19 é um dos principais recursos de saúde pública para mitigar a pandemia globalmente. As taxas de vacinação dependem diretamente da aceitação e adesão da população. Sabese que a aceitação vacinal é muito heterogênea entre as diferentes regiões do globo, mas há poucos estudos avaliando a percepção geral das vacinas contra a COVID-19 no Brasil. OBJETIVO: Avaliar a intenção de vacinação contra COVID-19 entre moradores do Rio Grande do Sul (RS), Brasil, durante o início da campanha de vacinação no país, e identificar fatores associados à hesitação vacinal. MÉTODOS: Foi realizada uma pesquisa com coleta de dados online, que recrutou um total de 953 respondentes. O questionário foi divulgado em mídias digitais de março a maio de 2021, por meio do método de amostragem bola de neve. RESULTADOS: Aproximadamente 96% da amostra informou que pretendia tomar a vacina contra a COVID-19. A hesitação vacinal foi positivamente associada a ser casado, ter filhos e ser mais velho. Indivíduos sem intenção de se vacinar também foram mais propensos a não respeitar o distanciamento social e outras ações de proteção individual. CONCLUSÕES: Nossos achados estão de acordo com os dados atuais de cobertura vacinal no RS. Embora o Brasil esteja apresentando taxas de vacinação superiores à maioria dos países do mundo, devemos atentar para os grupos populacionais que não aderem à vacinação. Reforçamos a importância da constante divulgação científica e educação em saúde para toda a população como aliadas no fortalecimento das políticas públicas de vacinação.(AU)

INTRODUCTION: The vaccination against COVID-19 is one of the major public health resources to mitigate the global pandemic. Vaccination rates directly depends on the acceptance and adherence by the population. It is known that the vaccine acceptancy is very heterogeneous among different regions of the globe, but there are few studies evaluating the general perception of COVID-19 vaccines in Brazil. AIM: To evaluate the intention of vaccination against COVID-19 among residents of Rio Grande do Sul (RS), Brazil, during the beginning of the campaign in the country, and to identify factors associated with vaccine hesitancy. METHODS: An online survey was conducted, ending in a sample of 953 respondents. The questionnaire was divulgated through digital medias from March to May 2021, via a snowball sampling method. RESULTS: Approximal 96% of the sample informed they intended to take COVID-19 vaccine. Vaccine hesitancy was positively associated with being married, having children, and being older. Subjects with no intention to get vaccinated were also more likely to not respect social distancing and other individual protection actions. CONCLUSIONS: Our findings are in line with current vaccination coverage data in RS. Although Brazil is showing vaccination rates higher than most countries in the world, we must pay attention to population groups that do not adhere to vaccination. We reinforce the importance of constant science communication and health education for the whole population as allies in strengthening public policies for vaccination.(AU)

INTRODUCCIÓN: La vacunación contra el COVID-19 es uno de los principales recursos de salud pública para mitigar la pandemia. Las tasas de vacunación dependen directamente de la aceptación y adherencia por parte de la población. Se sabe que la aceptación de la vacuna es muy heterogénea entre las diferentes regiones del mundo, pero hay pocos estudios que evalúen la percepción general de las vacunas contra la COVID-19 en Brasil. OBJETIVO: Evaluar la intención de vacunación contra la COVID-19 entre los residentes de Rio Grande do Sul (RS), Brasil, e identificar factores asociados a la reticencia vacunal. MÉTODOS: Se realizó una encuesta en línea, finalizando en una muestra de 953 encuestados. El cuestionario fue divulgado a través de medios digitales de marzo a mayo de 2021, mediante un método de muestreo de bola de nieve. RESULTADOS: Aproximadamente 96% de la muestra informó que tenía la intención de recibir la vacuna COVID-19. La reticencia a la vacuna se asoció positivamente con estar casado, tener hijos y ser mayor. Los sujetos sin intención de vacunarse también tenían más probabilidades de no respetar el distanciamiento social y otras medidas de protección individual. CONCLUSIONES: Nuestros hallazgos están en línea con los datos actuales de cobertura de vacunación en RS. Debemos prestar atención a los grupos de población que no se adhieren a la vacunación. Reforzamos la importancia de la comunicación científica constante y la educación en salud para toda la población como aliados en el fortalecimiento de las políticas públicas de vacunación.(AU)

Playful interventions to promote the subjective wellbeing of pediatric cancer inpatients during laboratory and imaging exams: A qualitative study.

PURPOSE: We investigate the experience of pediatric oncology patients with objects and equipment involved in laboratory and image examinations during hospitalization for cancer treatment while generating guidelines for playful interventions to improve their subjective wellbeing. METHOD: The study was carried out at a public tertiary referral teaching hospital in Southern Brazil. Data collection was based on participatory observations with six children aged 4-8 years. Their experiences with exams were observed through pretend play and recorded in field diaries, audio, and video. Data were analyzed using Thematic Analysis and discussed according to the PERMA-V model, a theoretical framework from positive psychology. RESULTS: Several objects and equipment that seem to affect the wellbeing of children during exams were identified. Four playful interventions were proposed as supportive care initiatives: use of technology to allow immersive experiences in learning about treatment and medical condition; design for personalization; gamifying experiences to allow positive reinforcement; and design for focus redirection. CONCLUSIONS: Guidelines for playful interventions to foster the subjective wellbeing of hospitalized children during image and laboratory exams were proposed. The PERMA-V model provided a solid base for the analysis of the interventions, which will be implemented and tested in future studies in clinical settings.

Memory bias and personality characteristics in college students with social anxiety disorder.

INTRODUCTION: Some individuals are more susceptible to recalling false information about events that never happened in their life. Nevertheless, there are several factors, such as personality characteristics, that appear to be related to memory performance. Social anxiety also provokes memory deficits for events that happen to other people, because these individuals tend to focus on their own inner selves rather than on external signs. OBJECTIVE: To investigate the influence of the personality characteristics of individuals with social anxiety disorder (SAD) on memory performance. METHODS: In this study, 183 university students had their memory tested using a complex emotional story about a mother and her son. Only subjects without clinical symptoms of depression and general anxiety (N = 148; 61 with SAD) were included in the study. Participants were compared for differences in personality characteristics using the Factorial Inventory of Personality and for SAD using the Social Phobia Inventory. RESULTS: The main results showed that memory performance of individuals with low percentile ranks in the personality characteristic dominance, i.e., those with low self-esteem, remembered more true information about the story than those with high scores when they did not have SAD. CONCLUSION: The results are helpful to foster better understanding of the personality characteristics related to SAD, such as low dominance, which implies low self-esteem and difficulties with trust and with imposing themselves on others. The results could help development and improvement of techniques for therapeutic intervention.

A comunicação de más notícias em Unidade de Terapia Intensiva: um estudo qualitativo com médicos experientes e novatos / Communicating bad news in the Intensive Care Unit: a qualitative study with experienced and novice physicians / La communication des mauvaises nouvelles dans l'unité de soins intensifs: Une étude qualitative auprès de médecins expérimentés et novices / La comunicación de malas noticias en la Unidad de Cuidados Intensivos: un estudio cualitativo con médicos experimentados y novatos

Resumo A Unidade de Terapia Intensiva (UTI) se caracteriza pela alta complexidade, monitoramento contínuo e ininterrupto, destinando-se ao atendimento de pacientes críticos. Comunicar más notícias neste ambiente gera sentimentos intensos para o paciente e seus familiares. O objetivo deste estudo foi compreender como os médicos percebem o processo de comunicação de más notícias na UTI, bem como identificar os fatores que facilitam e dificultam este processo, e os sentimentos gerados no profissional. Os 15 médicos participantes responderam um questionário online com perguntas abertas e fechadas. O processo de comunicação de más notícias foi considerado difícil e emotivo, independentemente do tempo de atuação em UTI. O conhecimento sobre a história do paciente e de seus familiares foi um fator facilitador e as mudanças inesperadas no quadro clínico do paciente foram fatores dificultadores do processo de comunicação. Os médicos reconheceram a necessidade de desenvolver competências para aprimorar a relação com paciente e famílias.

Abstract Characterized by highly complex, continuous and uninterrupted monitoring, the Intensive Care Unit (ICU) focuses on providing care for critically ill patients. Communicating bad news in this environment generates intense feelings for patients and families. Thus, this study sought to understand how experienced and novice physicians perceive the process of communicating bad news in the ICU, as well as to identify the factors that facilitate and hinder this process, and the feelings generated in the professional. A total of 15 physicians answered an online questionnaire with open and closed questions. Participants reported that the process of communicating bad news is difficult and emotional regardless of ICU length of stay. Knowledge about the patients' history and their families emerged as a facilitating factor, whereas unexpected changes in the patient's clinical condition hindered the communication process. Physicians recognized the need to develop skills as to improve physician-patient relations.

Résumé Caractérisée par une surveillance hautement complexe, continue et ininterrompue, l'unité de soins intensifs (USI) se concentre sur la prise en charge des patients gravement malades. Communiquer de mauvaises nouvelles dans cet environnement génère des sentiments intenses pour les patients et les familles. Cette étude a donc cherché à comprendre comment les médecins expérimentés et novices perçoivent le processus de communication des mauvaises nouvelles dans l'USI, ainsi qu'à identifier les facteurs qui facilitent et entravent ce processus, et les sentiments générés chez le professionnel. Au total, 15 médecins ont répondu à un questionnaire en ligne comportant des questions ouvertes et fermées. Les participants ont indiqué que le processus de communication de mauvaises nouvelles est difficile et émotionnel, quelle que soit la durée du séjour à l'USI. La connaissance de l'histoire des patients et de leur famille est apparue comme un facteur facilitant, tandis que les changements inattendus dans l'état clinique du patient entravaient le processus de communication. Les médecins ont reconnu la nécessité de développer des compétences afin d'améliorer les relations médecin-patient.

Resumen La Unidad de Cuidados Intensivos (UCI) se caracteriza por tener un monitoreo continuo e ininterrumpido de alta complejidad, destinado a la atención de pacientes críticos. Comunicar malas noticias en este ambiente genera sentimientos intensos para el paciente y sus familiares. El objetivo de este estudio fue comprender cómo los médicos perciben el proceso de comunicación de malas noticias en la UCI, así como identificar los factores que facilitan y dificultan ese proceso, y los sentimientos generados en el profesional. Los 15 médicos participantes respondieron un cuestionario en línea con preguntas abiertas y cerradas. El proceso de comunicar malas noticias se consideró difícil y emotivo, independiente del tiempo de estadía en la UCI. El conocimiento sobre la historia del paciente y sus familiares fue un factor facilitador, y los cambios inesperados en la condición clínica del paciente fueron los factores que dificultaron el proceso de comunicación. Los médicos reconocieron la necesidad de desarrollar habilidades para mejorar la relación con los pacientes y las familias.

Memory bias and personality characteristics in college students with social anxiety disorder

Abstract Introduction Some individuals are more susceptible to recalling false information about events that never happened in their life. Nevertheless, there are several factors, such as personality characteristics, that appear to be related to memory performance. Social anxiety also provokes memory deficits for events that happen to other people, because these individuals tend to focus on their own inner selves rather than on external signs. Objective To investigate the influence of the personality characteristics of individuals with social anxiety disorder (SAD) on memory performance. Methods In this study, 183 university students had their memory tested using a complex emotional story about a mother and her son. Only subjects without clinical symptoms of depression and general anxiety (N = 148; 61 with SAD) were included in the study. Participants were compared for differences in personality characteristics using the Factorial Inventory of Personality and for SAD using the Social Phobia Inventory. Results The main results showed that memory performance of individuals with low percentile ranks in the personality characteristic dominance, i.e., those with low self-esteem, remembered more true information about the story than those with high scores when they did not have SAD. Conclusion The results are helpful to foster better understanding of the personality characteristics related to SAD, such as low dominance, which implies low self-esteem and difficulties with trust and with imposing themselves on others. The results could help development and improvement of techniques for therapeutic intervention.

Uma intervenção cognitivo-comportamental em grupo com indivíduos com obesidade: resultados preliminares / A cognitive behavioral group intervention with obese patients: preliminary results / Uma intervenciión cognitiva conductual em grupo com individuos obesos: resultados preliminares

A obesidade tem causas multifatoriais e a Terapia Cognitivo-Comportamental apresenta resultados positivos sobre os aspetos cognitivos, emocionais e comportamentais relativos à perda de peso. Este estudo apresenta uma avaliação preliminar do Programa Cognitivo Comportamental de Educação Alimentar em Grupo (PROMETA). Foi realizado um estudo quantitativo, pré-experimental com avaliação pré e pós-teste. Sessenta e sete participantes adultos com sobrepeso ou obesidade realizaram as 12 sessões da intervenção em grupos. Foram utilizados os inventários Beck de depressão, de ansiedade, e de desesperança, a escala de compulsão alimentar periódica, e a escala de figuras de silhuetas. Os resultados indicaram que o PROMETA contribuiu para redução de sintomas de depressão, ansiedade, desesperança, e compulsão alimentar. Portanto, o programa apresenta resultados satisfatórios para esta amostra.

Obesity has multifactorial causes and Cognitive-Behavioral Therapy has positive results on cognitive, emotional, and behavioral aspects related to weight loss. This study presents a preliminary assessment of the Cognitive Behavioral Program for Group Food Education (PROMETA). A quantitative, pre-experimental study was carried out with pre- and post-test evaluation. Sixty-seven adults who were overweight or obese participated of 12 intervention sessions in groups. Instruments included the Beck inventories of depression, anxiety, and hopelessness, a periodic binge eating scale, and a body satisfaction scale. Results indicated that PROMETA contributed to the reduction of symptoms of depression, anxiety, hopelessness, and binge eating. Therefore, the program shows satisfactory results for this sample.

La obesidad tiene causas multifactoriales y la terapia cognitivo-conductual tiene resultados positivos en los aspectos cognitivos, emocionales y conductuales relacionados con la pérdida de peso. Este estudio demuestra una evaluación preliminar del Programa de comportamiento cognitivo para la educación alimentaria grupal - PROMETA. Se llevó a cabo un estudio cuantitativo pre-experimental con evaluación previa y posterior a la prueba. Se realizaron 67 participantes adultos con sobrepeso u obesidad como 12 intervenciones de intervención en grupos. Se utilizó el inventivo Beck de depresión, ansiedad y desesperanza, una escala periódica de atracones y una escala de figuras de personajes. Los resultados indicaron que PROMETA contribuyó a la reducción de los síntomas de depresión, ansiedad, desesperanza y atracones. Por tanto, el programa muestra resultados satisfactorios para esta muestra.

Playful strategies to foster the well-being of pediatric cancer patients in the Brazilian Unified Health System: a design thinking approach.

BACKGROUND: Cancer care can negatively impact children's subjective well-being. In this research, well-being refers to patients' self-perception and encompasses their hospital and care delivery assessment. Playful strategies can stimulate treatment compliance and have been used to provide psychosocial support and health education; they can involve gamification, virtual reality, robotics, and healthcare environments. This study aims to identify how playfulness, whenever applicable, can be used as a strategy to improve the subjective well-being of pediatric cancer patients in the Brazilian Unified Health System. METHODS: Sixteen volunteers with experience in pediatric oncology participated in the study. They were physicians, psychologists, child life specialists, and design thinking professionals. They engaged in design thinking workshops to propose playful strategies to improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Data collection consisted of participatory observations. All activities were video recorded and analyzed through Thematic Analysis. The content generated by the volunteers was classified into two categories: impact of cancer care on children's self-perception and children's perceptions of the hospital and the care delivery. RESULTS: Volunteers developed strategies to help children deal with time at the hospital, hospital structure, and care delivery. Such strategies are not limited to using playfulness as a way of "having fun"; they privilege ludic interfaces, such as toys, to support psychosocial care and health education. They aim to address cancer and develop communication across families and staff in a humanized manner, educate families about the disease, and design children-friendly environments. Volunteers also generated strategies to help children cope with perceptions of death, pain, and their bodies. Such strategies aim to support understanding the meaning of life and death, comprehend pain beyond physicality, help re-signify cancer and children's changing bodies, and give patients active voices during the treatment. CONCLUSIONS: The paper proposes strategies that can improve the well-being of pediatric cancer patients in the Brazilian Unified Health System. Such strategies connect children's experiences as inpatients and outpatients and may inform the implementation of similar projects in other developing countries.

Cuidados em saúde mental ofertados a profissionais de saúde durante a pandemia de Covid-19 / Mental health care offered to health professionals during the Covid-19 pandemic

Este artigo traz aspectos relacionados à atenção à saúde mental dos trabalhadores da saúde da linha de frente durante a pandemia da Doença Coronavírus-2019. O estudo qualitativo teve como objetivo compreender as ações de cuidado em saúde mental ofertadas aos trabalhadores da saúde pública diretamente atuantes no combate à doença e descrever as implicações emocionais que os profissionais de saúde mental experienciaram no trabalho desenvolvido. No município de Lajeado/RS, os profissionais da linha de frente receberam apoio psicossocial e psicoterapia breve por sete psicólogas voluntárias que relataram sua percepção sobre a saúde mental desses profissionais e os desafios do atendimento presencial. Trechos das entrevistas foram utilizados para ilustrar os resultados, a partir das categorias analisadas à luz da análise de conteúdo. Os resultados foram classificados em três categorias: o estado de saúde mental dos trabalhadores de linha de frente, apoio oferecido a esses profissionais, e apoio recebido pelos profissionais de saúde mental para a realização dessas atividades. A análise indicou que muitos profissionais, tanto da linha de frente quanto da saúde mental, referiram sintomas psicológicos desencadeados ou agravados pela pandemia, preocupações com a possibilidade de contaminar alguém próximo, invisibilidade das necessidades em saúde mental da população, e a falta de investimento nesse setor.(AU)

This article presents aspects related to the mental health care of frontline health workers during the 2019 Coronavirus Disease pandemic. The qualitative study aimed to understand the mental health care actions offered to public health workers directly active in combating the disease and to describe the emotional implications that mental health professionals experienced in the work developed. In the municipality of Lajeado/RS, frontline professionals received psychosocial support and brief psychotherapy by seven volunteer psychologists who reported their perception of the mental health of these professionals and the challenges of face-to-face care. Excerpts from the interviews were used to illustrate the results from the categories analyzed in the light of the content analysis. The results were classified into three categories: mental health of frontline workers, support offered to these professionals, and support received by mental health professionals to carry out these activities. The analysis indicated that many professionals, both from the front line and from mental health, referred to psychological symptoms triggered or aggravated by the pandemic, concerns about the possibility of contaminating someone close to them, invisibility of the population's mental health needs, and the lack of investment in this. sector.(AU)

Este artículo presenta aspectos relacionados con la atención de la salud mental de los trabajadores de la salud de primera línea durante la pandemia de la enfermedad por coronavirus de 2019. El estudio cualitativo tuvo como objetivo comprender las acciones de atención en salud mental que se ofrecen a los trabajadores de salud pública directamente activos en la lucha contra la enfermedad y describir las implicaciones emocionales que los profesionales de la salud mental experimentaron en el trabajo desarrollado. En el municipio de Lajeado/RS, los profesionales de primera línea recibieron apoyo psicosocial y psicoterapia breve por parte de siete psicólogos voluntarios que informaron su percepción sobre la salud mental de estos profesionales y los desafíos de la atención presencial. Se utilizaron extractos de las entrevistas para ilustrar los resultados de las categorías analizadas a la luz del análisis de contenido. Los resultados se clasificaron en tres categorías: salud mental de los trabajadores de primera línea, apoyo ofrecido a estos profesionales y apoyo recibido por los profesionales de la salud mental para llevar a cabo estas actividades. El análisis indicó que muchos profesionales, tanto de primera línea como de salud mental, refirieron síntomas psicológicos desencadenados o agravados por la pandemia, inquietudes sobre la posibilidad de contaminar a alguien cercano, invisibilidad de las necesidades de salud mental de la población, y la carencia de inversión en este sector.(AU)

Desenvolvimento e Relato de Experiência de um Protocolo de Primeiros Cuidados Psicológicos a Distância (PCPd) durante a Pandemia COVID-19 / Development and Experience Report of a Protocol of Psychological First Aid on line (PFAo) during the COVID-19 Pandemic

A pandemia e as medidas para conter sua propagação tiveram efeitos significativos na saúde mental da população em geral e na dos profissionais da linha de frente nos atendimentos. Como consequência, o impacto em saúde mental pode ser considerado uma nova emergência sanitária. No entanto, os protocolos de atendimento não foram desenvolvidos para o contexto atual. Portanto, o objetivo do presente estudo foi adaptar o protocolo de Primeiros Cuidados Psicológicos desenvolvido pela Organização Mundial da Saúde para a modalidade de atendimento a distância (PCPd), bem como, relatar a experiência de sua aplicação em termos de perfil dos atendidos, principais demandas e técnicas aplicadas, e encaminhamento. Foram realizados atendimentos usando o protocolo PCPd a 15 participantes classificados como em sofrimento psicológico em um estudo prévio realizado para levantamento de saúde mental. A maioria dos participantes era do gênero feminino (73%) e possuía histórico de doenças psiquiátricas (60%). Com relação às demandas, 87% (n=13) dos participantes relataram causas de sofrimento mental atreladas à pandemia, particularmente em função da sobrecarga decorrente do excesso de demandas nas atividades domésticas e de trabalho. Foram utilizadas técnicas de normalização e de resolução de problemas no atendimento em quase todos os casos. Devido a alta intensidade de estresse e de ansiedade foi necessário aplicar técnicas de respiração diafragmática em três casos e o teste de realidade em um caso. Com relação ao encaminhamento, 40% dos participantes já estavam em atendimento psicoterápico e os demais foram encaminhados. Salienta-se que 20% optou por modalidades online de encaminhamento. Por fim, o presente relato de experiência apresenta a adequação do PCPd às necessidades de cuidados psicológicos a distância diante da emergência causada pela pandemia, bem como, a potencialidade do protocolo adaptado em promover suporte inicial e encaminhamento a rede de saúde mental. Estudos experimentais e mais controlados poderão fornecer mais evidências da prática desenvolvida.(AU)

The pandemic and measures to contain its spread had major effects on the mental health of the general population and of frontline professionals. As a consequence, the impact on mental health can be considered a new healthcare emergency, but the healthcare protocols were not developed for the current context. Thus, the goal of the present study was to adapt the Psychological First Aid protocol developed by the World Health Organization to the online health service (PFAo), as well as to report the experience of its application in terms of patients profile, key demands and techniques used for treatment, and forwarding. Consultations were carried out using PFAo protocol to 15 participants classified as having psychological distress in a previous survey. Most participants were female (73%) and had a history of psychiatric illness (60%). Regarding the demands, 87% of participants reported that their primary causes of mental suffering were linked to the pandemic, particularly due to the overload resulting from the overwhelming demands in their home and work activities. Normalization and problem solving techniques were used during consultations in almost all cases. Due to intense stress and anxiety observed in participants, diaphragmatic breathing techniques were recommended to three patients and reality test was used to one. With regard to referral, 40% of participants were already receiving psychological care and the remaining ones were referred to local psychotherapists. About 20% of participants showed a preference for online referral modalities. Finally, the present experience report shows the adequacy of the PFAo to the needs of psychological online healthcare in the face of the emergency caused by the pandemic, as well as the potential of the adapted protocol to promote initial support and referral to mental health network. Experimental and more controlled studies may provide more evidence of the developed practice.(AU)

La pandemia y las medidas para contener su propagación tuvieron efectos importantes en la salud mental de la población en general y de los profesionales de primera línea. Como consecuencia, el impacto en la salud mental puede considerarse una nueva emergencia sanitaria, pero los protocolos sanitarios no se desarrollaron para el contexto actual. Así, el objetivo del presente estudio fue adaptar el protocolo de Primera Ayuda Psicológica desarrollado por la Organización Mundial de la Salud a la modalidad de atención a distancia (PAPd), así como reportar la experiencia de su aplicación en términos de perfil del paciente, demandas clave y técnicas utilizadas para el tratamiento y reenvío. Las consultas se llevaron a cabo mediante el protocolo PAPd a 15 participantes clasificados como con distrés psicológico. La mayoría de los participantes eran mujeres (73%) y tenían antecedentes de enfermedad psiquiátrica (60%). En cuanto a las demandas, el 87% de los participantes refirió que sus principales causas de sufrimiento mental estaban vinculadas a la pandemia, particularmente por la sobrecarga resultante de las abrumadoras demandas en sus actividades domésticas y laborales. Se utilizaron técnicas de normalización y resolución de problemas durante las consultas en casi todos los casos. Debido al intenso estrés y ansiedad observados en los participantes, se recomendaron técnicas de respiración diafragmática a tres pacientes y se utilizó una prueba de realidade a uno. En cuanto a el referimiento, el 40% de los participantes ya estaban recibiendo atención psicológica y los restantes fueron derivados a psicoterapeutas locales. Aproximadamente el 20% de los participantes mostró preferencia por las modalidades on line. Finalmente, el presente relato de experiencia muestra la adecuación del PAPd a las necesidades de la atención psicológica online ante la emergencia provocada por la pandemia, así como el potencial del protocolo adaptado para promover el apoyo inicial y lo referimiento a la red de salud mental. Los estudios experimentales y más controlados pueden proporcionar más evidencia de la práctica desarrollada.(AU)

Development and Validation of a Predictive Model of Success in Bariatric Surgery.

PURPOSE: There are no criteria to establish priority for bariatric surgery candidates in the public health system in several countries. The aim of this study is to identify preoperative characteristics that allow predicting the success after bariatric surgery. MATERIALS AND METHODS: Four hundred and sixty-one patients submitted to Roux-en-Y gastric bypass were included. Success of the surgery was defined as the sum of five outcome variables, assessed at baseline and 12 months after the surgery: excess weight loss, use of continuous positive airway pressure (CPAP) or bilevel positive airway pressure (BiPAP) as a treatment for obstructive sleep apnea (OSA), daily number of antidiabetics, daily number of antihypertensive drugs, and all-cause mortality. Partial least squares (PLS) regression and multiple linear regression were performed to identify preoperative predictors. We performed a 90/10 split of the dataset in train and test sets and ran a leave-one-out cross-validation on the train set and the best PLS model was chosen based on goodness-of-fit criteria. RESULTS: The preoperative predictors of success after bariatric surgery included lower age, presence of non-alcoholic fatty liver disease and OSA, more years of CPAP/BiPAP use, negative history of cardiovascular disease, and lower number of antihypertensive drugs. The PLS model displayed a mean absolute percent error of 0.1121 in the test portion of the dataset, leading to accurate predictions of postoperative outcomes. CONCLUSION: This success index allows prioritizing patients with the best indication for the procedure and could be incorporated in the public health system as a support tool in the decision-making process.

Influência da percepção de risco sobre a COVID-19 no sofrimento psicológico dos profissionais de saúde / Influence of risk perception of COVID-19 on psychological distress of health professionals / Influencia de la percepción de riesgo del COVID-19 en el sufrimiento psicológico de los profesionales de la salud

A saúde mental dos profissionais de saúde da linha de frente durante a pandemia da doença coronavírus 2019 (COVID-19) está relacionada a uma percepção qualitativa de risco sobre a doença, segundo a Teoria do Traço Difuso. Uma pesquisa de levantamento foi realizada com 134 profissionais de saúde da linha de frente em um município da região metropolitana do Rio Grande do Sul. Os participantes responderam a um questionário on-line sobre percepção de risco e a Clinical Outcome Routine Evaluation - Outcome Measure. Análises de regressão linear corroboraram a literatura, indicando que a percepção qualitativa do risco estava relacionada a menor sofrimento psicológico e uma avaliação quantitativa, a maior sofrimento. Os resultados demonstraram a importância da Teoria do Traço Difuso para compreensão dos riscos associados ao sofrimento mental (potencialmente clínico) de profissionais de saúde durante a pandemia

Mental health of frontline health professionals during the coronavirus disease 2019 (COVID-19) pandemic is related to a qualitative perception of risk about the disease, according to Fuzzy Trace Theory. A survey was carried out with 134 frontline health professionals in a city within the metropolitan area of Rio Grande do Sul. Participants answered an online questionnaire on risk perception and the Clinical Outcome Routine Evaluation - Outcome Measure. Linear regression analysis corroborated the literature, indicating that a qualitative perception of risk was related to less psychological distress and, a quantitative assessment, to greater suffering. Results showed the importance of Fuzzy-Trace Theory for understanding the risks associated with (potentially clinical) psychological distress of health professionals during the pandemic

La salud mental de los profesionales de la salud de primera línea, durante la pandemia de enfermedad por coronavirus 2019 (COVID-19), está relacionada con una percepción cualitativa de riesgo sobre la enfermedad, según la Teoría del Rasgo Difuso. Se realizó una encuesta a 134 profesionales de la salud de primera línea en un municipio de la región metropolitana de Río Grande del Sur. Los participantes respondieron un cuestionario en línea sobre percepción de riesgo y la Clinical Outcome Routine Evaluation ­ Outcome Measure. Los análisis de regresión lineal corroboraron la literatura, indicando que la percepción cualitativa del riesgo se relacionó con un menor sufrimiento psicológico y, una valoración cuantitativa, con un mayor sufrimiento. Los resultados demuestran la importancia de la Teoría del Rasgo Difuso para comprender los riesgos asociados con el sufrimiento mental (potencialmente clínico) de los profesionales de la salud durante la pandemia

O papel da remuneração na decisão de participar de pesquisa na saúde el papel de / El papel de la remuneración en la decisión de participar en la investigación en salud / The role of remuneration in the decision to participate in health research / El paper de la remuneració en la decisió de participar en la recerca en salut

O processo de consentimento informado para participação de pesquisa com seres humanos visa fornecer as informações adequadas ao indivíduo possibilitando que este tome a decisão de participar de maneira voluntária, livre de pressões externas. A possibilidade de remuneração poderia interferir na voluntariedade deste processo de consentir. O presente estudo objetivou avaliar percepção de influência da remuneração monetária por meio de simulações de pesquisa que variam em nível de risco (Bioequivalência e de Fase I) e tipo de remuneração monetária (com e sem). Participaram do estudo 80 voluntários. Os resultados sugerem que a remuneração não constituiu uma interferência na voluntariedade do processo de consentimento, visto que participantes aceitaram convite para participar da primeira pesquisa para a qual foram convidados e não se sentiram influenciados indebidamente

El proceso de consentimiento informado para la participación de sujetos humanos en investigación tiene por objeto dar la información adecuada al individuo, permitiendo que tome la decisión de participar de manera voluntaria y libre de presiones externas. La posibilidad de remuneración podría interferir en la voluntariedad de este proceso de consentir. El presente estudio evalúa la percepción de la influencia de la remuneración monetaria a través de simulaciones de investigación que varían en nivel de riesgo (Bioequivalencia y de Fase I) y tipo de remuneración monetaria (con y sin). Participaron del estudio 80 voluntarios. Los resultados sugieren que la remuneración no constituyó una interferencia en la voluntariedad del proceso de consentimiento, ya que los participantes aceptaron una invitación para participar en la primera encuesta a la que fueron invitados y no se sintieron influenciados incorrectamente

The process of informed consent for research participation with human beings aims to provide appropriate information to individuals enabling him or her to make the decision to participate voluntarily, free of external pressures. The possibility of remuneration could interfere in the willingness to consent. The present study aims to evaluate the perception of influence of the monetary payment through research simulations that vary in the level of risk (Bioequivalence and Phase I) and type of monetary payment (with and without). Eighty volunteers participated in the study. The results suggest that remuneration did not interfere with the willingness of the consent process, as participants accepted an invitation to participate in the first research option to which they were invited to and did not feel undue influence

El procés de consentiment informat per a la participació de subjectes humans en recerca té per objecte donar la informació adequada a l'individu, permetent que prengui la decisió de participar de manera voluntària I lliure de pressions externes. La possibilitat de remuneració podria interferir en la voluntarietat d'aquest procés de consentir. El present estudi avalua la percepció de la influència de la remuneració monetària a través de simulacions de recerca que varien en nivell de risc (Bioequivalencia I de Fase I) I tipus de remuneració monetària (amb I sense). Van participar de l'estudi 80 voluntaris. Els resultats suggereixen que la remuneració no va constituir una interferència en la voluntarietat del procés de consentiment, ja que els participants van acceptar una invitació per a participar en la primera enquesta a la qual van ser convidats I no es van sentir influenciats incorrectament

A randomized clinical trial of group and individual Cognitive-Behavioral Therapy approaches for Social Anxiety Disorder / Un ensayo clínico aleatorizado de Terapia Cognitivo-Conductual grupal e individual para el Trastorno de ansiedad social

To compare the effectiveness of two Cognitive-Behavioral Therapy (CBT) interventions-an individual and a group intervention-in Social Anxiety Disorder therapy. We compared the two treatment groups against a waitlist condition in a randomized clinical trial with 86 young adults. The individual CBT intervention was Trial-Based Cognitive Therapy (TBCT) developed by De-Oliveira, a novel technique in which the therapist engages the patient in a simulated judicial trial with the goal of identifying and changing core dysfunctional beliefs. The group intervention consisted of exposition therapy based on the Hofmann and Otto protocol (Group CBT) to restructure negative and dysfunctional cognitions regarding social situations. Both interventions reduced psychiatric symptoms from pre- to post-test and primary social anxiety and depression symptoms relative to waitlist controls. The interventions were recently introduced in Brazil, and this is the first randomized control trial to compare TBCT and this Group CBT, which were effective in assessing changes in social anxiety symptoms as well as co-occurring psychiatric symptoms

Comparar la efectividad de dos intervenciones de Terapia Cognitivo-Conductual (TCC)-intervención individual y grupal- en tratamiento del Trastorno de ansiedad social. Comparamos los dos grupos de tratamiento con una condición de lista de espera en un ensayo clínico aleatorizado con 86 adultos jóvenes. La intervención individual de TCC fue la Terapia Cognitiva Basada en Ensayos (TCBE) desarrollada por De-Oliveira, una técnica novedosa en la cual el terapeuta involucra al paciente en un juicio judicial simulado con el objetivo de identificar y cambiar las creencias disfuncionales centrales. La intervención grupal consistió en terapia de exposición basada en el protocolo Hofmann y Otto (TCC grupal) para reestructurar cogniciones negativas y disfuncionales con respecto a situaciones sociales. Ambas intervenciones redujeron los síntomas psiquiátricos antes y después de la prueba y los síntomas de ansiedad y depresión social primarios en relación con los controles de la lista de espera. Las intervenciones se introdujeron recientemente en Brasil, y este es el primer ensayo de control aleatorizado para comparar TCBE y TCC grupal, que fueron efectivos para los cambios en los síntomas de ansiedad social y los síntomas psiquiátricos concurrentes

A randomized clinical trial of group and individual Cognitive-Behavioral Therapy approaches for Social Anxiety Disorder.

To compare the effectiveness of two Cognitive-Behavioral Therapy (CBT) interventions-an individual and a group intervention-in Social Anxiety Disorder therapy. We compared the two treatment groups against a waitlist condition in a randomized clinical trial with 86 young adults. The individual CBT intervention was Trial-Based Cognitive Therapy (TBCT) developed by De-Oliveira, a novel technique in which the therapist engages the patient in a simulated judicial trial with the goal of identifying and changing core dysfunctional beliefs. The group intervention consisted of exposition therapy based on the Hofmann and Otto protocol (Group CBT) to restructure negative and dysfunctional cognitions regarding social situations. Both interventions reduced psychiatric symptoms from pre- to post-test and primary social anxiety and depression symptoms relative to waitlist controls. The interventions were recently introduced in Brazil, and this is the first randomized control trial to compare TBCT and this Group CBT, which were effective in assessing changes in social anxiety symptoms as well as co-occurring psychiatric symptoms.

Comparar la efectividad de dos intervenciones de Terapia Cognitivo-Conductual (TCC)-intervención individual y grupal- en tratamiento del Trastorno de ansiedad social. Comparamos los dos grupos de tratamiento con una condición de lista de espera en un ensayo clínico aleatorizado con 86 adultos jóvenes. La intervención individual de TCC fue la Terapia Cognitiva Basada en Ensayos (TCBE) desarrollada por De-Oliveira, una técnica novedosa en la cual el terapeuta involucra al paciente en un juicio judicial simulado con el objetivo de identificar y cambiar las creencias disfuncionales centrales. La intervención grupal consistió en terapia de exposición basada en el protocolo Hofmann y Otto (TCC grupal) para reestructurar cogniciones negativas y disfuncionales con respecto a situaciones sociales. Ambas intervenciones redujeron los síntomas psiquiátricos antes y después de la prueba y los síntomas de ansiedad y depresión social primarios en relación con los controles de la lista de espera. Las intervenciones se introdujeron recientemente en Brasil, y este es el primer ensayo de control aleatorizado para comparar TCBE y TCC grupal, que fueron efectivos para los cambios en los síntomas de ansiedad social y los síntomas psiquiátricos concurrentes.

Decision Support for Breast Cancer Detection: Classification Improvement Through Feature Selection.

Several statistical-based approaches have been developed to support medical personnel in early breast cancer detection. This article presents a method for feature selection aimed at classifying cases into categories based on patients' breast tissue measures and protein microarray. The effectiveness of this feature selection strategy was evaluated against the commonly used Wisconsin Breast Cancer Database-WBCD (with several patients and fewer features) and a new protein microarray data set (with several features and fewer patients). Features were ranked according to a feature importance index that combines parameters emerging from the unsupervised method of principal component analysis and the supervised method of Bhattacharyya distance. Observations of a training set were iteratively categorized into malignant and benign cases through 3 classification techniques: k-Nearest Neighbor, linear discriminant analysis, and probabilistic neural network. After each classification, the feature with the smallest importance index was removed, and a new categorization was carried out until there was only one feature left. The subset yielding maximum accuracy was used to classify observations in the testing set. Our method yielded average 99.17% accurate classifications in the testing set while retaining average 4.61 out of 9 features in the WBCD, which is comparable to the best results reported by the literature on that data set, with the advantage of relying on simple and widely available multivariate techniques. When applied to the microarray data, the method yielded average accuracy of 98.30% while retaining average 2.17% of the original features. Our results can aid health-care professionals during early diagnosis of breast cancer.

False memories in social anxiety disorder

Abstract Background False memories are memories of events that never occurred or that occurred, but not exactly as we recall. Events with emotional content are subject to false memories production similar to neutral events. However, individual differences, such as the level of maladjustment and emotional instability characteristics of Social Anxiety Disorder (SAD), may interfere in the production of false memories. Objectives This study aimed to assess the effect of emotion in memory performance for an event witnessed by participants with and without SAD. Methods Participants were 61 young adults with SAD and 76 without any symptoms of SAD who were randomly assigned to watch a story with or without emotional arousal. Participants answered a subjective scale of emotion about the story and a recognition memory test. Results Participants with SAD recovered more true memories and more false memories for the non-emotional version compared to the emotional version of the story. Overall, participants with SAD produced fewer false memories compared to those without SAD. Discussion This finding suggests that social anxiety may have a significant impact on emotional memory accuracy, which may assist in the development and improvement of techniques for therapeutic intervention.