Brief intervention protocol by telephone delivered by nurses to patients with harmful alcohol use in primary health care: A feasibility trial.

AIM: The aim of this study is to examine the feasibility of a brief intervention protocol by telephone performed by nurses in primary health care facilities. METHODS: A nonrandomized single-arm feasibility study was performed. The proposed intervention of this study is the Brief Intervention carried out by the nurse delivered by telephone, synchronously with alcohol users. The brief intervention is a motivational approach based on the FRAMES model, with its components being: Feedback, Responsibility, Advice, Menu of options, Empathy and Self-efficacy. To assess the feasibility of the protocol, we evaluated the procedure for enrolling participants, the acceptability of the protocol to participants, the satisfaction of the participants, convenience and treatment continuity. The quantitative data analysis was carried out in the R software, using descriptive statistics, categorical variables were reported by frequencies and percentages. For continuous variables, medians, means, standard deviations and range values were computed. RESULTS: We followed the participants (n = 165) from baseline (T0) until 3 months (T1) and 6 months (T2) after the brief intervention. The partial effect suggests a reduction in alcohol consumption, and statistically significant differences were observed from baseline before the BI, with a decrease of 0.66 points in AUDIT scores at T1. Among the patients who completed the 3-month follow-up, 48 % reported a positive experience of receiving the brief intervention by the nurses, and 44 % reported a decrease in alcohol consumption. CONCLUSIONS: Brief intervention delivered by telephone was considered feasible and acceptable by primary health care patients, and they perceived improvement in their alcohol consumption after receiving the BI performed by nurses.

A Narrative Review on the Pathophysiology of Preeclampsia.

Preeclampsia (PE) is a multifactorial pregnancy disorder characterized by hypertension and proteinuria, posing significant risks to both maternal and fetal health. Despite extensive research, its complex pathophysiology remains incompletely understood. This narrative review aims to elucidate the intricate mechanisms contributing to PE, focusing on abnormal placentation, maternal systemic response, oxidative stress, inflammation, and genetic and epigenetic factors. This review synthesizes findings from recent studies, clinical trials, and meta-analyses, highlighting key molecular and cellular pathways involved in PE. The review integrates data on oxidative stress biomarkers, angiogenic factors, immune interactions, and mitochondrial dysfunction. PE is initiated by poor placentation due to inadequate trophoblast invasion and improper spiral artery remodeling, leading to placental hypoxia. This triggers the release of anti-angiogenic factors such as soluble fms-like tyrosine kinase-1 (sFlt-1) and soluble endoglin (sEng), causing widespread endothelial dysfunction and systemic inflammation. Oxidative stress, mitochondrial abnormalities, and immune dysregulation further exacerbate the condition. Genetic and epigenetic modifications, including polymorphisms in the Fms-like tyrosine kinase 1 (FLT1) gene and altered microRNA (miRNA) expression, play critical roles. Emerging therapeutic strategies targeting oxidative stress, inflammation, angiogenesis, and specific molecular pathways like the heme oxygenase-1/carbon monoxide (HO-1/CO) and cystathionine gamma-lyase/hydrogen sulfide (CSE/H2S) pathways show promise in mitigating preeclampsia's effects. PE is a complex disorder with multifactorial origins involving abnormal placentation, endothelial dysfunction, systemic inflammation, and oxidative stress. Despite advances in understanding its pathophysiology, effective prevention and treatment strategies remain limited. Continued research is essential to develop targeted therapies that can improve outcomes for both mothers and their babies.

Using modified trapping regimes to understand the behavioral and spatial ecology of Philornis downsi (Diptera: Muscidae).

The avian vampire fly Philornis downsi (Dodge & Aitken) (Diptera: Muscidae) is native to continental South America and the Caribbean, but invasive in the Galapagos Archipelago. The larvae of P. downsi feed on the blood and tissues of the nestlings of 75% of the small land bird species that are endemic or native to Galapagos, causing high in-nest mortality and severe population declines in some species. Efficient trapping techniques are vital to safeguarding these birds in the short term as well as for monitoring fly populations, but basic information about the ecology of the fly is still needed to help develop a species-appropriate trapping method. In this study, we used a novel trapping regime with a vertical distribution to make inferences about P. downsi's behavioral and spatial ecology and to optimize trap catch. Our results showed that male and female P. downsi were trapped in greater numbers below the canopy (3.1-7.5 m), lower down than other commonly caught insect species (5.1-11.5 m). Notably, the effect of trap height remained consistent across seasons and different weather conditions. These findings suggest that P. downsi tend to move at heights where their hosts nest (at or below the canopy) and do not spend time above the canopy. This also makes it unlikely that strategies such as hill-topping or aerial swarming are being used to locate mates. As such, trapping and control efforts should be focused below the canopy in forests with similar canopy heights to effectively capture P. downsi and reduce bycatch of other insects.

Teleenfermería en salud mental: efecto sobre los síntomas de ansiedad y el consumo de alcohol durante la pandemia de COVID-19 / Telenursing in mental health: effect on anxiety symptoms and alcohol consumption during the COVID-19 pandemic / Telenfermagem em saúde mental: efeito em sintomas de ansiedade e consumo de álcool durante a pandemia COVID-19

Objetivo: investigar el efecto de una intervención a distancia sobre los síntomas de ansiedad y el consumo de alcohol en usuarios del servicio de Atención Primaria de Salud. Método: estudio cuasiexperimental, realizado con 1270 participantes que respondieron al Alcohol Use Disorders Identification Test y al State-Trait Anxiety Inventory 6. De estos, 1033 encuestados obtuvieron puntajes de síntomas de ansiedad moderada/grave (STAI-6 > 3) y consumo de alcohol de riesgo moderado/grave (AUDIT-C>3), y recibieron las intervenciones mediante llamada telefónica con un seguimiento de siete y 180 días. Para analizar los datos se utilizó un modelo de regresión de efectos mixtos. Resultados: el efecto de la intervención realizada fue positivo para reducir los síntomas de ansiedad entre T0 y T1 (µ=1,6 p<0,001) y para reducir el patrón de consumo de alcohol entre t1 y t3 (µ=1,57 p< 0,001). Conclusión: los resultados del seguimiento sugieren que la intervención tuvo un efecto positivo en la reducción de la ansiedad y el patrón de consumo de alcohol que tiende a mantenerse en el tiempo. Existe evidencia de que la intervención propuesta puede ser una alternativa para la atención preventiva en salud mental, en situaciones donde se comprometa la accesibilidad del usuario o del profesional.

Objective: to investigate the effect of a remote intervention on anxiety symptoms and alcohol use in users of the Primary Health Care service. Method: a quasi-experimental study conducted with 1,270 participants who answered the Alcohol Use Disorders Identification Test and the State-Trait Anxiety Inventory-6. Of these, 1,033 interviewees scored for moderate/severe anxiety symptoms (STAI-6 > 3) and moderate/severe risk alcohol use (AUDIT-C > 3), and received the interventions via telephone calls with follow-up periods lasting seven and 180 days. For data analysis, a mixed-effects regression model was used. Results: the effect of the intervention performed was positive in reducing anxiety symptoms between T0 and T1 (µ=1.6, p<0.001) and in reducing the alcohol use pattern between T1 and T3 (µ=1.57, p<0.001) Conclusion: the follow-up results suggest a positive effect of the intervention in reducing anxiety and the alcohol use pattern, which tends to be maintained over time. There is diverse evidence that the intervention proposed can be an alternative for preventive care in mental health, in situations where accessibility of the user or the professional is compromised.

Objetivo: investigar o efeito de uma intervenção remota nos sintomas de ansiedade e no uso de álcool em usuários do serviço de Atenção Primária à Saúde. Método: estudo quase experimental, realizado com 1270 participantes que responderam o Alcohol Use Disorders Identification Test e a State-Trait Anxiety Inventory 6. Desses, 1033 entrevistados pontuaram para sintomas de ansiedade moderada/severa (STAI-6>3) e uso de risco de álcool moderado/severo (AUDIT-C>3), e receberam as intervenções via chamada telefônica com follow-up de sete e 180 dias. Para análise dos dados utilizou-se um modelo de regressão de efeitos mistos. Resultados: o efeito da intervenção realizada foi positivo na redução dos sintomas de ansiedade entre T0 e T1 (µ=1,6 p<0.001) e na redução do padrão de uso de álcool entre t1 e t3 (µ=1,57 p<0.001). Conclusão: os resultados do follow-up sugerem efeito positivo da intervenção na redução da ansiedade e no padrão de uso de álcool, o qual tende a se manter ao longo do tempo. Há evidências de que a intervenção proposta pode ser uma alternativa para o cuidado preventivo em saúde mental, em situações nas quais a acessibilidade do usuário ou do profissional encontram-se comprometidas.

Chemogenetic regulation of the TARP-lipid interaction mimics LTP and reversibly modifies behavior.

Long-term potentiation (LTP), a well-characterized form of synaptic plasticity, is believed to underlie memory formation. Hebbian, postsynaptically expressed LTP requires TARPγ-8 phosphorylation for synaptic insertion of AMPA receptors (AMPARs). However, it is unknown whether TARP-mediated AMPAR insertion alone is sufficient to modify behavior. Here, we report the development of a chemogenetic tool, ExSYTE (Excitatory SYnaptic Transmission modulator by Engineered TARPγ-8), to mimic the cytoplasmic interaction of TARP with the plasma membrane in a doxycycline-dependent manner. We use this tool to examine the specific role of synaptic AMPAR potentiation in amygdala neurons that are activated by fear conditioning. Selective expression of active ExSYTE in these neurons potentiates AMPAR-mediated synaptic transmission in a doxycycline-dependent manner, occludes synaptically induced LTP, and mimics freezing triggered by cued fear conditioning. Thus, chemogenetic controlling of the TARP-membrane interaction is sufficient for LTP-like synaptic AMPAR insertion, which mimics fear conditioning.

Telenursing in mental health: effect on anxiety symptoms and alcohol consumption during the COVID-19 pandemic. / Teleenfermería en salud mental: efecto sobre los síntomas de ansiedad y el consumo de alcohol durante la pandemia de COVID-19.

OBJECTIVE: (1) A remote intervention with a positive impact on reducing anxiety and alcohol use. (2) Nursing as a protagonist of preventive care in mental health (3) A low-cost intervention that covers several population groups. (4) Telenursing in mental health as a care strategy during COVID-19. to investigate the effect of a remote intervention on anxiety symptoms and alcohol use in users of the Primary Health Care service. METHOD: a quasi-experimental study conducted with 1,270 participants who answered the Alcohol Use Disorders Identification Test and the State-Trait Anxiety Inventory-6. Of these, 1,033 interviewees scored for moderate/severe anxiety symptoms (STAI-6 > 3) and moderate/severe risk alcohol use (AUDIT-C > 3), and received the interventions via telephone calls with follow-up periods lasting seven and 180 days. For data analysis, a mixed-effects regression model was used. RESULTS: the effect of the intervention performed was positive in reducing anxiety symptoms between T0 and T1 (µ=1.6, p<0.001) and in reducing the alcohol use pattern between T1 and T3 (µ=1.57, p<0.001). CONCLUSION: the follow-up results suggest a positive effect of the intervention in reducing anxiety and the alcohol use pattern, which tends to be maintained over time. There is diverse evidence that the intervention proposed can be an alternative for preventive care in mental health, in situations where accessibility of the user or the professional is compromised.

Y chromosome sequence and epigenomic reconstruction across human populations.

Recent advances in long-read sequencing technologies have allowed the generation and curation of more complete genome assemblies, enabling the analysis of traditionally neglected chromosomes, such as the human Y chromosome (chrY). Native DNA was sequenced on a MinION Oxford Nanopore Technologies sequencing device to generate genome assemblies for seven major chrY human haplogroups. We analyzed and compared the chrY enrichment of sequencing data obtained using two different selective sequencing approaches: adaptive sampling and flow cytometry chromosome sorting. We show that adaptive sampling can produce data to create assemblies comparable to chromosome sorting while being a less expensive and time-consuming technique. We also assessed haplogroup-specific structural variants, which would be otherwise difficult to study using short-read sequencing data only. Finally, we took advantage of this technology to detect and profile epigenetic modifications among the considered haplogroups. Altogether, we provide a framework to study complex genomic regions with a simple, fast, and affordable methodology that could be applied to larger population genomics datasets.

Internal validity evidence of a knowledge questionnaire on alcohol use, abuse and dependence and associated questions.

OBJECTIVES: to perform content validity and verify the psychometric properties of the adapted version of an alcohol knowledge questionnaire and associated questions. METHODS: a methodological study, in which a committee of judges analyzed the questionnaire item representativeness, clarity and relevance. Item response theory was used to assess the instrument psychometric properties applied to a sample of 240 health professionals. RESULTS: the questions were adjusted according to judges' assessment, obtaining a satisfactory Content Validity Index (0.98). High discrimination ability and adequate difficulty levels were observed in 75% of multiple-choice questions and in 25% of statements. CONCLUSIONS: the instrument presented content validity with satisfactory indices. However, it is recommended that the questionnaire adapted in this study be used in different samples of health professionals from other parts of Brazil, in order to provide greater robustness to its reliability.

Internal validity evidence of a knowledge questionnaire on alcohol use, abuse and dependence and associated questions / Evidencia de validez interna de un cuestionario de conocimientos sobre uso, abuso y dependencia de alcohol y preguntas asociadas / Evidências de validade interna de um questionário de conhecimento sobre o uso, abuso e dependência de álcool e questões associadas

ABSTRACT Objectives: to perform content validity and verify the psychometric properties of the adapted version of an alcohol knowledge questionnaire and associated questions. Methods: a methodological study, in which a committee of judges analyzed the questionnaire item representativeness, clarity and relevance. Item response theory was used to assess the instrument psychometric properties applied to a sample of 240 health professionals. Results: the questions were adjusted according to judges' assessment, obtaining a satisfactory Content Validity Index (0.98). High discrimination ability and adequate difficulty levels were observed in 75% of multiple-choice questions and in 25% of statements. Conclusions: the instrument presented content validity with satisfactory indices. However, it is recommended that the questionnaire adapted in this study be used in different samples of health professionals from other parts of Brazil, in order to provide greater robustness to its reliability.

RESUMEN Objetivos: realizar la validación de contenido y verificar las cualidades psicométricas de la versión adaptada del cuestionario de conocimientos sobre alcohol y preguntas asociadas. Métodos: estudio metodológico, en el que un comité de jueces analizó la representatividad, claridad y pertinencia de los ítems del cuestionario. Se utilizó la teoría de respuesta al ítem para evaluar las cualidades psicométricas del instrumento aplicado a una muestra de 240 profesionales de la salud. Resultados: las preguntas fueron ajustadas de acuerdo a la evaluación de los jueces, obteniendo un Índice de Validez de Contenido satisfactorio (0,98). Se observó una alta capacidad de discriminación y niveles de dificultad adecuados en el 75% de las preguntas de opción múltiple y en el 25% de las afirmativas. Conclusiones: el instrumento presentó validez de contenido con índices satisfactorios. Sin embargo, se recomienda que el cuestionario adaptado en este estudio sea utilizado en diferentes muestras de profesionales de la salud de otras partes del país, con el fin de darle mayor robustez a su confiabilidad.

RESUMO Objetivos: realizar a validação de conteúdo e verificar as qualidades psicométricas da versão adaptada do questionário de conhecimentos frente ao álcool e questões associadas. Métodos: estudo do tipo metodológico, em que um comitê de juízes analisou a representatividade, clareza e pertinência dos itens do questionário. Utilizou-se a teoria da resposta ao item para avaliar as qualidades psicométricas do instrumento aplicado em uma amostra de 240 profissionais de saúde. Resultados: as questões foram ajustadas conforme avaliação dos juízes, obtendo um Índice de Validade de Conteúdo satisfatório (0,98). Observou-se alta capacidade de discriminação e níveis de dificuldade adequados em 75% das questões de múltipla escolha e em 25% das afirmativas. Conclusões: o instrumento apresentou validade de conteúdo com índices satisfatórios. Entretanto, recomenda-se que o questionário adaptado neste estudo seja utilizado em amostras diversas de profissionais de saúde, de outros locais do país, com o intuito de oferecer maior robustez à sua confiabilidade.

Effectiveness of a Brief Group Intervention for Harmful Alcohol Use in Men at a Primary Health Care Facility in Brazil: A Randomized Clinical Trial.

To evaluate the effectiveness of a brief group intervention (BGI) in reducing the use of alcohol and increasing the readiness to change in men with risky and harmful alcohol use. A randomized clinical trial with follow-ups at 30 and 90 days that was conducted in a primary health care (PHC) facility in the central region of São Paulo (Brazil). A total of 112 men were randomized to the experimental group (EG) (n = 55) or the control group (CG) (n = 57). To identify the pattern of alcohol use and the readiness to change, the Alcohol Use Disorders Identification Test (AUDIT) and the readiness to change (RTC) rule were used. The EG received a BGI session applied by nurses using the Feedback, Responsibility, Advice, Menu of options, Empathy, Self-efficacy (FRAMES) model. The CG was instructed to continue with the standard service of the unit after an initial interview. Intergroup analyses using the generalized equation estimation (GEE) method were performed. A significant difference in the pattern of use was observed between the EG and CG at follow-up evaluated (EG T1 (7.73 ± 5.14), CG T1 (12, 48 ± 5.62)) and EG T2 (6.65 ± 4.83), CG T2 (11.68 ± 6.65)). When compared the baseline (T0) measures (13.04) with the last time (T2) (6.65) at EG, it was identified a reduction of 6.39 in the AUDIT score. Differences between groups were found for readiness to change at follow-up ((EG T1 (8.50 ± 2.44) and CG T1 (5.67 ± 3.10) and (EG T2 (8.80 ± 1.73) and CG T2 (5.36 ± 3.33)), when contrasting with the baseline. The data suggest that the BGI was effective when compared to the control condition, as there was a reduction in risky and harmful use of alcohol for low-risk use, according to the alcohol use scores, and an increase in the stages of readiness to change.

Protein tyrosine phosphatase 1B inhibitory activity of compounds from Justicia spicigera (Acanthaceae).

An infusion from the aerial parts of Justicia spicigera Schltdl., an herb commonly used to treat diabetes, inhibited the activity of protein tyrosine phosphatase 1B (PTP1B). Two undescribed compounds, 2-N-(p-coumaroyl)-3H-phenoxazin-3-one, and 3″-O-acetyl-kaempferitrin, along with kaempferitrin, kaempferol 7-O-α-L-rhamnopyranoside, perisbivalvine B and 2,5-dimethoxy-p-benzoquinone were isolated from the active extract. Their structures were elucidated by a combination of spectroscopic and spectrometric methods. The isolates were evaluated for their inhibitory activity against PTP1B; the most active compounds were 2-N-(p-coumaroyl)-3H-phenoxazin-3-one, and perisbivalvine B with IC50 values of 159.1 ± 0.02 µM and 106.6 ± 0.01 µM, respectively. However, perisbivalvine B was unstable. Kinetic analysis of 2-N-(p-coumaroyl)-3H-phenoxazin-3-one and 2,5-dimethoxy-p-benzoquinone (obtained in good amounts) indicated that both compounds behaved as parabolic competitive inhibitors and bind to the enzyme forming complexes with 1:1 and 1:2 stoichiometry. Docking of 2-N-(p-coumaroyl)-3H-phenoxazin-3-one and 2,5-dimethoxy-p-benzoquinone to PTP1B1-400 predicted a good affinity of these compounds for PTP1B catalytic site and demonstrated that the binding of a second ligand is sterically possible. The 1:2 complex was also supported by the second docking analysis, which predicted an important contribution of π-stacking interactions to the stability of these 1:2 complexes. Finally, an UHPLC-MS method was developed and validated to quantify the content of kaempferitrin in the infusion of the plant.

Alcohol Use and Anxiety in Primary Health Care Patients During the COVID-19 Pandemic: a Phone-Based Study.

In March 2020, physical distancing and quarantine measures were implemented in Brazil, which may have affected the physical and mental health of the population. This cross-sectional study used a convenience sample and telephone-based interviews to identify anxiety symptoms and alcohol use patterns among 1,264 Brazilian primary health care (PHC) patients during the COVID-19 pandemic. The State-Trait Anxiety Inventory-State 6 and Alcohol Use Disorders Identification Test (AUDIT-C) questionnaires were used to assess anxiety symptoms and alcohol use patterns, respectively. According to the AUDIT-C results, the prevalence of harmful drinking was 38.5%. Those who reported that their alcohol consumption decreased during the pandemic had high scores on the AUDIT-C, indicating a moderate/severe risk of drinking. Moderate or severe anxiety was observed in 60.1% of participants. These results highlight the needs to assess the pandemic's consequences on the mental health of the population and to encourage the implementation of preventive approaches in PHC settings to address anxiety and harmful alcohol consumption.

Nursing students' attitudes towards alcohol use disorders and related issues: A comparative study in four American countries.

The present study identified and compared the attitudes of nursing students from North and South American countries towards alcohol, alcohol use disorders and persons with alcohol use disorders (AUDs). A cross-sectional design and survey approach were used. The sample consisted of 327 nursing students recruited from four nursing schools in metropolitan regions of North and South America. The questionnaire contained questions about sex, age, marital status, home country and other questions about training in substance use disorders during nursing education and previous experiences with substance use disorder patients. To identify nursing students' attitudes, validated English, Spanish and Portuguese versions of the attitudes scale for alcohol, alcoholism and persons with AUDs (EAFAA) were applied. Comparison of the four groups suggested that nursing students in the United States demonstrated more positive attitudes than students from Colombia, Mexico and Brazil. Similar positive attitudes were observed towards individuals with AUDs. Results of the attitudes towards the aetiology of AUDs showed positive attitudes in all samples, suggesting a contemporary understanding of AUDs. Nursing students' attitudes were associated with home country and training in substance use disorders during nursing education. Nursing students' attitudes were generally positive across countries. Idiosyncratic cultural and educational aspects in these countries and world regions likely significantly influenced the attitudes of nursing students towards alcohol and associated issues.

Antinociceptive Effect of an Aqueous Extract and Essential Oil from Baccharis heterophylla.

Infusions and poultices prepared from the aerial parts of Baccharis heterophylla Kunth (Asteraceae) are widely used in Oaxaca (Mexico) for relieving painful and inflammatory complaints. Therefore, the antinociceptive potential of an aqueous extract (31.6-316 mg/kg, p.o.) and essential oil (30-177 µg/paw, i.pl.) of the plant was assessed using the formalin test. Both preparations inhibited the formalin-induced nociception response (100-316 mg/kg and 100-177 µg/paw, respectively) during the test's second phase. Chemical analysis of the aqueous extract revealed that the major active components were chlorogenic acid (1), 3,4-di-O-(E)-caffeoylquinic acid (2), 3,5-di-O-(E)-caffeoylquinic acid (3), 4,5-di-O-(E)-caffeoylquinic acid (4), 3,5-di-O-(E)-caffeoylquinic acid methyl ester (5), apigenin (6), genkwanin (7), acacetin (8). Compounds 1-5 and 8 are new for B. heterophylla. A high-pressure liquid chromatographic method for quantifying chlorogenic acid (1) and di-caffeoylquinic acids 2-4 in the plant was developed and validated. Analyses of the essential oil and the headspace solid-phase microextraction products, via gas-chromatography-mass spectrometry, revealed that the major volatiles were ß-pinene, myrcene, D-limonene, ß-caryophyllene, and α-caryophyllene, which have demonstrated antinociceptive properties.

Suicidal ideation in gender and sexual minority students in the largest Brazilian University.

OBJECTIVE: Identifying the presence of suicidal ideation and associated factors among university students from a public university in Brazil. METHODS: A cross-sectional study was performed with 72 university students between 18 and 29 years old. Were used a sociodemographic data questionnaire and the Beck's Suicidal Ideation Scale. RESULTS: The suicidal ideation was significantly in the participants, as well as the association of gender, gender identity, sexual orientation and housing with it. CONCLUSIONS: The suicidal ideation in this population is important, and there is a need to explore the factors related, such as gender, sexual orientation, gender identity and housing.

Health Professionals' Attitudes Toward Alcoholism and Associated Issues: A Comparative Study in a Brazilian Sample.

Attitudes of health professionals have an effect on the quality of care provided to individuals with alcohol use disorders. The identification of health professionals' attitudes supports strategies that promote positive attitudes and improve the quality of the health care provided to this population. This is a descriptive cross-sectional study with 831 health professionals. Data were collected using the scale of attitudes toward alcohol, alcohol use disorder, and individuals with alcohol use disorders. Pearson test, Analysis of Variance, and Bayesian linear regression were used to analyze the data. There was a predominance of positive attitudes among all professional categories, with the exception of attitudes toward the etiology of alcohol use disorder and attitudes toward alcoholic beverages and their use. The respondent's age and professional category influenced his or her attitudes toward alcohol and associated issues. There are differences in the attitudes of professionals from different professional groups, which may contribute to inconsistencies in the care provided for individuals with alcohol use disorders. The results of our study suggest that strategies regarding the training and continuing education of health professionals that consider the particularities of each profession be instituted to improve professionals' attitudes, thus improving their ability to address issues related to alcohol use disorders and encourage alcoholic patients to engage in treatment.

Cystathionine ß-synthase and methylenetetrahydrofolate reductase mutations in Mexican individuals with hyperhomocysteinemia.

BACKGROUND: Hyperhomocysteinemia, a thrombotic risk factor, may have several causes. Among the genetic causes of hyperhomocysteinemia, there are polymorphisms in the enzymes methylenetetrahydrofolate reductase (C677T) and cystathionine ß-synthase (C699T, C1080T, and 844ins68). Although the frequency of hyperhomocysteinemia in our country is high, there is no evidence about the frequencies of these polymorphisms. METHODS: We analyzed 80 healthy individuals from several regions in our country. We evaluated the fasting and post-oral methionine load plasma Hcy and the genotypes in order to obtain the allele frequencies of the polymorphisms C677T of methylenetetrahydrofolate reductase and C699T, C1080T, and 844ins68 of the cystathionine ß-synthase. RESULTS: No individual had deficiency of folic acid, vitamins B12, or B6, but 80% had post-oral methionine load hyperhomocysteinemia. We found a significant increase in the Hcy plasma concentration associated with age and gender. Only the polymorphism C1080T was significantly associated with hyperhomocysteinemia. CONCLUSION: There is an association between fasting and post-oral methionine load plasma Hcy concentrations with the allelic frequencies of the polymorphisms C669T, 844ins68, and C1080T of the cystathionine ß-synthase and C667T of the methylenetetrahydrofolate reductase in healthy Mexican individuals. As compared with individuals with normal fasting or post-oral methionine load Hcy plasma levels, only C1080T was significantly associated with hyperhomocysteinemia.

O cuidado espiritual realizado pela enfermagem na unidade de terapia intensiva / The spiritual care carried out by nursing in the intensive care unit / El cuidado espiritual realizado por enfermería en la unidad de cuidados intensivos

CONTEXTO: Esta revisão busca responder como a enfermagem tem abordado a espiritualidade no processo de cuidar na Unidade de Terapia Intensiva (UTI), contribuindo na compreensão das dificuldades e fatores que possam melhorar a atuação destes profissionais neste ambiente de ambivalência entre a vida e a morte dos pacientes. OBJETIVO: Verificar os artigos existentes na literatura sobre os cuidados espirituais prestados pela equipa de enfermagem em UTI. MÉTODOS: Foi utilizado o método de revisão integrativa, sendo as buscas realizadas entre 2008 a 2018 nas bases de dados Medline, Lilacs, Cinahl e no portal PubMed. Foram utilizados chaves de busca com os descritores Spirituality, Nursing, Team, Intensive Care Units, Systematization of Nursing Care e suas variações em português e espanhol, com os operadores booleanos AND e/ou OR. RESULTADOS: Foram encontrados na literatura 381 artigos, sendo que ao final do processo foram incluídos quatro artigos que descreviam os cuidados espirituais prestados pela equipa de enfermagem em UTI. Foram elencadas três categorias que tratam da temática: Processo de Enfermagem e os cuidados espirituais; b) Bem-estar espiritual; c) Desafios na assistência aos cuidados espirituais. CONCLUSÕES: A espiritualidade dentro do processo de cuidar foi relatada em poucos estudos e de forma fragmentada. Mostrou-se importante o cuidar de si para cuidar do outro, além de aspectos relacionados ao enfrentamento de desafios. A enfermagem necessita ter um olhar mais amplo do cuidado espiritual, para que possa ofertar o cuidado sistematizado e com embasamento científico.

BACKGROUND: This review seeks to answer how nursing has addressed spirituality in the care process in the Intensive Care Unit (ICU), contributing to the understanding of the difficulties and factors that can improve the performance of these professionals in this ambivalent environment between patients' lives and deaths. AIM: Verify the existing studies in the literature on spiritual care provided by the nursing team in the ICU. METHODS: The integrative review method was used, and the searches performed between 2008 and 2018 in the databases Medline, Lilacs, Cinahl and the PubMed portal. The search keys were used with the descriptors Spirituality, Nursing, Team, Intensive Care Units, Systematization of Nursing Care and its variations in Spanish and Portuguese, using Boolean operators AND and/or OR. RESULTS: In the literature, 381 articles were found and, at the end of the process, four articles were included that presented the spiritual care provided by the ICU nursing team. Three categories that address the issue were listed: a) Nursing process and spiritual care; b) Spiritual well-being; c) Challenges in assisting spiritual care. CONCLUSIONS: Spirituality within the attention process has been reported in few studies and of fragmented way. It was important to take care of yourself to take care of others, as well as aspects related to the facing challenges. Nursing needs to have a broader vision of spiritual care, so that it can offer systematized care scientific basis.

CONTEXTO: Esta revisión busca dar respuesta a cómo la enfermería ha abordado la espiritualidad en el proceso de cuidado en la Unidad de Cuidados Intensivos (UCI), contribuyendo a la comprensión de las dificultades y factores que pueden mejorar el desempeño de estos profesionales en este ambiente ambivalente entre la vida y la muerte de los pacientes. OBJETIVO: Verificar los artículos existentes en la literatura sobre el cuidado espiritual proporcionado por el equipo de enfermería en las UCI. METODOLOGÍA: Se utilizó el método de revisión integradora con las búsquedas realizadas entre 2008 y 2018 en las bases de datos LILACS, MEDLINE, PubMed y Cinahl. Las claves de búsqueda se utilizaron con los descriptores Spirituality, Nursing, Team, Intensive Care Units, Systematization of Nursing Care y sus variaciones en portugués e español, com los operadores booleanos Y y/o OR. RESULTADOS: En la literatura, se encontraron 381 artículos y, al final del proceso, se incluyeron cuatro artículos que incluían el cuidado espiritual proporcionado por el equipo de enfermería de la UCI. Se enumeraron tres categorías que abordan el tema: a) Proceso de enfermería y el cuidado espiritual; b) Bienestar espiritual; c) Retos en la asistencia del cuidado espiritual. CONCLUSIONES: La espiritualidad dentro del proceso de atención se ha informado en pocos estudios y de forma fragmentada. Resulta importante cuidarse a sí mismo para cuidar de los demás, así como los aspectos relacionados con los desafíos que enfrenta. La enfermería necesita tener una visión más amplia del cuidado espiritual, de modo que pueda ofrecer un cuidado sistematizado y con base científica.