Right to health and encouragement of social participation in elementary education.

OBJECTIVES: Develop and validate an ordinary meeting simulation template of the Municipal Health Council applied to students of cycle II of Elementary School. METHODS: Qualitative and descriptive research developed in two phases: construction of simulation scenario of ordinary meeting of the Municipal Health Council and validation by committee of experts who analyzed the representativeness and adequacy of the content. The scenario included the items: prebriefing, additional information about the case, scenario objectives, evaluation criteria (observers), scenario duration time, human and physical resources, instructions for the actors, context, references and debriefing. In order to be able to understand which items should be modified according to the evaluations of the experts, it was used as criterion that only items that had 80% or higher percentage of agreement between the experts for modification would be modified. RESULTS: There was agreement to modify the prebriefing in: additional information about the case (100%); learning objectives (88.8%); human and physical resources (88.8%); context (88.8%); and in the debriefing (88.8%). The prebriefing did not reach the level of agreement: evaluation criteria (66.6%), duration of the scenario (77.7%), instruction for authors (77.7%), references (77.7%), which were modified. CONCLUSIONS: With the template developed and then validated by the committee of experts, it will be possible to develop in the classroom content related to the right to health and social participation in the scope of elementary education, as well as encourage engagement in important bodies for the maintenance of democracy, justice and social equity.

Right to health and encouragement of social participation in elementary education / Derecho a la salud e incentivo a la participación social en la educación básica / Direito à saúde e o estímulo à participação social na educação básica

Objective Develop and validate an ordinary meeting simulation template of the Municipal Health Council applied to students of cycle II of Elementary School. Methods. Qualitative and descriptive research developed in two phases: construction of simulation scenario of ordinary meeting of the Municipal Health Council and validation by committee of experts who analyzed the representativeness and adequacy of the content. The scenario included the items: prebriefing, additional information about the case, scenario objectives, evaluation criteria (observers), scenario duration time, human and physical resources, instructions for the actors, context, references and debriefing. In order to be able to understand which items should be modified according to the evaluations of the experts, it was used as criterion that only items that had 80% or higher percentage of agreement between the experts for modification would be modified. Results. There was agreement to modify the prebriefing in: additional information about the case (100%); learning objectives (88.8%); human and physical resources (88.8%); context (88.8%); and in the debriefing (88.8%). The prebriefing did not reach the level of agreement: evaluation criteria (66.6%), duration of the scenario (77.7%), instruction for authors (77.7%), references (77.7%), which were modified. Conclusion. With the template developed and then validated by the committee of experts, it will be possible to develop in the classroom content related to the right to health and social participation in the scope of elementary education, as well as encourage engagement in important bodies for the maintenance of democracy, justice and social equity

Objetivo. Desarrollar y validar una plantilla de simulación de una reunión ordinaria del Consejo Municipal de Salud aplicada a estudiantes del ciclo II de Enseñanza Fundamental. Métodos. Investigación cualitativa descriptiva desarrollada en dos fases: construcción de un escenario para simular una reunión ordinaria del Consejo Municipal de Salud y validación por un comité de expertos que analizó la representatividad y adecuación del contenido. El escenario incluyó los ítems: prebriefing, información adicional sobre el caso, objetivos del escenario, criterios de evaluación (observadores), tiempo de duración del escenario, recursos humanos y físicos, instrucciones para los actores, contexto, referencias y debriefing. Para validar el escenario, se definió un nivel de acuerdo entre los expertos de mínimo 80%. Resultados. Hubo acuerdo para mejorar en el prebriefing: información adicional sobre el caso (100%); objetivos de aprendizaje (88,8%); recursos humanos y físicos (88.8%); contexto (88.8%); y en el debriefing (88.8%). En el prebriefing no alcanzó el nivel de acuerdo: criterios de evaluación (66,6%), tiempo del escenario (77.7%), instrucciones para los autores (77.7%), y las referencias (77.7%), los cuales fueron posteriormente modificados. Conclusión. Con la plantilla desarrollada y posteriormente validada por expertos será posible realizar en el aula contenidos sobre el derecho a la salud y a la Participación Social en el ámbito de la educación básica, así como fomentar el compromiso en órganos importantes para el mantenimiento de la democracia, la justicia y la equidad social.

Objetivo. Desenvolver e validar um template de simulação de reunião ordinária do Conselho Municipal de Saúde aplicado em alunos do ciclo II do Ensino Fundamental. Método. Pesquisa qualitativa e descritiva desenvolvida em duas fases: construção de cenário de simulação de reunião ordinária do Conselho Municipal de Saúde e validação por comitê de especialistas que analisaram a representatividade e adequação do conteúdo. O cenário contemplou os itens: prebriefing, informações adicionais sobre o caso, objetivos do cenário, critérios de avaliação (observadores), tempo de duração do cenário, recursos humanos e físicos, instruções para os atores, contexto, referências e debriefing. Para que fosse possível entender quais itens deveriam ser modificados de acordo com as avaliações dos especialistas, utilizou-se como critério que somente os itens que tivessem 80% ou porcentagem superior de concordância entre os especialistas para modificação é que seriam modificados. Resultados. Houve concordância para modificação em el prebriefing em: informações adicionais sobre o caso (100%); objetivos de aprendizagem (88.8%); recursos humanos e físicos (88.8%); contexto (88.8%); y em el debriefing (88.8%). Não atingiram o nível de concordância o prebriefing: critérios de avaliação (66.6%), tempo de duração do cenário (77.7%), instrução para autores (77.7%), referências (77.7%), os quais foram modificados. Conclusão. Com o template desenvolvido e despois validado pelo comitê de especialistas será possível desenvolver em sala de aula conteúdos referentes ao direito à saúde e à Participação Social no âmbito da educação básica, bem como encorajar o engajamento em órgãos importantes para manutenção da democracia, justiça e equidade social.

Fear of cancer recurrence among Brazilian patients with cancer: Translation and cultural adaptation of FCR4/7 and FCRI-SF measures.

OBJECTIVE: Fear of cancer recurrence or progression (FCR) is considered one of the most common unmet needs among patients with cancer. This study sought to translate and evaluate the psychometric properties of the Fear of Cancer Recurrence scale (FCR4/7) and Fear of Cancer Recurrence Inventory-Short Form (FCRI-SF). METHODS: This study involved three phases: (1) translation and cultural adaptation of the FCR4/7 and FCRI-SF measures, (2) validity and reliability testing of the Portuguese version of these measures, and (3) examining patient's perceptions of these measures. Eligible patients were diagnosed with localized breast cancer, and patients with metastatic cancer. Descriptive analyses were collated, and psychometric analysis were conducted (confirmatory factor analysis). RESULTS: A total of 200 patients were recruited (100 patients with localized and 100 patients with metastatic cancer). A significant proportion of patients reported moderate to severe FCR (FCR7: 32.0% and FCRI-SF: 43.0%). Female gender, younger age and metastatic cancer were associated with higher levels of FCR. Psychometric analyses suggested that the Portuguese versions of the FCR4/7 and FCRI-SF were valid, unidimensional in nature, with acceptable reliability coefficients across all scales. In a sub-sample qualitative analysis (n = 75), most patients were satisfied with the relevance of both measures. CONCLUSION: Our findings suggest the Portuguese versions of the FCR4/7 and FCRI-SF are valid tools to assess FCR among patients with localized and metastatic cancer. Future research can now extend our understanding of FCR and assess this construct among Portuguese speaking patients, to guide the development of effective and targeted interventions for patients globally.

Tumor condromixoide ectomesenquimal: uma revisão sistemática e análise molecular de um caso extralingual / Ectomesenchymal chondromyxoid tumor: a systematic review and molecular analysis of an extra-lingual case

O tumor condromixoide ectomesenquimal (TCE) é uma neoplasia benigna rara, que afeta principalmente a língua e que exibe alta frequência da fusão RREB1-MRTFB. Microscopicamente, o TCE se assemelha com outras lesões condromixoides, sendo o mioepitelioma um dos principais desafios de diferenciação. Seu diagnóstico requer além da análise microscópica, a imuno-histoquímica. Revisões narrativas sobre o TCE já realizadas não contemplam uma análise sistemática da literatura. A fusão RREB1- MRTFB apesar de frequente em língua, foi positiva em um caso intra-ósseo, não tendo sido ainda descrita nos tecidos moles orais extra lingual. Sendo assim, o objetivo desse estudo foi sistematizar os dados da literatura com ênfase na microscopia do TCE, e relatar um caso extra lingual investigando a fusão RREB1-MRTFB. Uma busca eletrônica em 5 bases foi realizada em dezembro de 2021. Um total de 44 artigos com 101 casos de TCE foram incluídos. Microscopicamente, o TCE mostrou-se não encapsulado (95,5%), porém circunscrito (89,2%), de aspecto lobular (70,6%), entremeado por septos fibrosos (98%), sendo uma proliferação sólida em lençol, ilhas ou cordões (98%), em um padrão reticular (98,3%), cujas células eram fusiformes (77,5%), redondas e ovoides (70,6%) ou poligonais (54,9%), com citoplasma eosinofílico (34,3%), imersas em uma matriz mixoide (97,0%), condroide (88,0%) ou mixocondroide (X%). Na imuno-histoquímica as células mostraram maior positividade para vimentina (100%), GFAP (88,9%), S-100 (85,7%), CD56 (76,9%) e CD57 (75%). A fusão RREB1-MRTFB ocorreu em n=20/23; 87,0%. O presente caso clínico relatado é de um nódulo em face lingual da mandíbula em jovem de 15 anos, cuja morfologia mostrava as características mais frequentemente identificadas na revisão sistemática. A análise molecular confirmou o diagnóstico de TCE. O estudo contribui para um detalhamento das características morfológicas diagnósticas do TCE, bem como expandiu o conhecimento molecular do tumor em um caso extra lingual de um indivíduo brasileiro.

The ectomesenchymal chondromyxoid tumor (ECMT) is a rare benign neoplasm that mainly affects the tongue and exhibits a high frequency of the RREB1-MRTFB fusion. Microscopically, ECMT resembles other chondromyxoid lesions, with myoepithelioma being one of the main differentiation challenges. Its diagnosis requires not only microscopic analysis but also immunohistochemistry. Narrative reviews on ECMT conducted so far do not encompass a systematic analysis of the literature. The RREB1-MRTFB fusion, despite being frequent in the tongue, has been tested positive in an intraosseous case, and it has not yet been described in extra-lingual oral soft tissues.Therefore, the aim of this study was to systematize the literature data with an emphasis on ECMT microscopy and report an extra-lingual case investigating the RREB1-MRTFB fusion. An electronic search across 5 databases was conducted in December 2021. A total of 44 articles comprising 101 cases of ECMT were included. Microscopically, ECMT was found to be non-encapsulated (95.5%), yet circumscribed (89.2%), exhibiting a lobular appearance (70.6%), interspersed with fibrous septa (98%), forming a solid proliferation in sheets, strands and cords (98%) in a reticular pattern (98.3%). The cells were spindle-shaped (77.5%), round and ovoid (70.6%), or polygonal (54.9%), with eosinophilic cytoplasm (34.3%), embedded in a myxoid matrix (97.0%), and chondroid (88.0%). Immunohistochemically, there was higher positivity for vimentin (100%), GFAP (88.9%), S-100 (85.7%), CD56 (76.9%), and CD57 (75%). The RREB1-MRTFB fusion occurred in n=20/23; 87,0%. The present clinical case reportes a nodule on the lingual aspect of the mandible in a 15-year-old individual, whose morphology exhibited the most frequently identified characteristics in the systematic review. The molecular analysis confirmed the diagnosis of ECMT. The present study not only contributes to a detailed understanding of the morphological diagnostic features of ECMT but also expands the molecular knowledge of the tumor based in an extra-lingual case of a Brazilian individual.

A situational analysis of primary health care centers in Brazil: challenges and opportunities for addressing mental illness and substance use-related stigma.

BACKGROUND: The detrimental impact of stigma toward people with mental illness and substance use problems (MISUP) is well documented. However, studies focusing on stigma reduction in Latin American primary health care (PHC) contexts are limited. This situational analysis incorporating a socioecological framework aims to provide a comprehensive understanding of MISUP-related stigma in PHC centers in Brazil. The objectives of this analysis are twofold: (1) to understand the current mental health and substance use service delivery context and (2) identify challenges and opportunities for addressing MISUP-related stigma in PHC centers in Ribeirão Preto, Brazil. METHODS: Environmental scans of four Family Health Units were conducted in early 2018 to explore population needs and service delivery for individuals with MISUP. In addition, a symposium was organized in October 2018 to consult with diverse stakeholders and gather local perspectives about MISUP-related stigma conveyed in PHC settings. NVivo 12 software was used to conduct a thematic analysis of the qualitative data collected from the environmental scans and the symposium consultation. RESULTS: Themes identified at the national level in the socioecological framework indicate that political support for national policies related to reducing stigma is limited, particularly regarding social inclusion and the decentralization of mental health services. Themes at the regional, organizational, and interpersonal levels include insufficient mental health expertise and the limited involvement of those with lived experience in decision-making. Suggestions for stigma interventions were provided, including increased contact with individuals with lived experience outside of client-patient interactions, capacity building for professionals, and public education campaigns. CONCLUSION: Increased government support, capacity building, and promoting social inclusion will provide opportunities to reduce stigma and reach marginalized populations. These findings will assist with addressing current gaps in PHC mental health service provision and may inform anti-stigma strategies for Brazil and other Latin American low- and middle-income countries.

Stigma experienced by people with mental illness in South America: an integrative review

Introduction: People with mental illness are highly stigmatized by populations around the world and are perceived to be a burden on society. As a result of stigma, many people with mental illness are discriminated against, which leads to limited life opportunities. Given that beliefs about mental illness can vary based on culture, religion, nationality and ethnicity, it is important to understand the different types of mental illness-related stigma experienced around the world. Materials and Methods: Whittemore and Knafl's (2005) methodology for integrative reviews was used to analyze 18 studies about lived experiences of mental illness-related stigma in South America. Results: Findings suggest that certain types of stigma in South America are based on gender and social norms, such as the social position of men and women in society. This leads to discrimination, isolation and violence from family, intimate partners, friends, society and health professionals. Employment is also limited for South Americans with mental illness. Other consequences, such a self-stigma, also impact the lives of people with mental illness in many South American contexts. Discussion: Family, friendship and social relationships, including health professionals, can involve processes that lead to the stigma experienced by people with mental illness. Conclusion: This integrative review highlights how mental illness related-stigma impacts individuals in South America.

Introducción: Las personas con trastornos mentales están muy estigmatizadas por poblaciones de todo el mundo y son vistas como una carga para la sociedad. Muchas personas con trastornos mentales son discriminadas, lo que genera oportunidades de vida limitadas. Dado que las creencias sobre los trastornos mentales pueden variar según la cultura, la religión, la nacionalidad y la etnia, es importante comprender los diferentes tipos de estigma relacionados con el trastorno mental que se experimentan en todo el mundo. Materiales y métodos: Se utilizó la metodología de Whittemore y Knafl (2005) para revisiones integrativas para analizar 18 estudios sobre experiencias vividas de estigma relacionado con el trastorno mental en América del Sur. Resultados: Los resultados sugieren que ciertos tipos de estigma en América del Sur. se basan en normas sociales y de género, como la posición social de hombres y mujeres en la sociedad. Esto conduce a la discriminación, el aislamiento y la violencia por parte de la familia, la pareja íntima, los amigos, la sociedad y los profesionales de la salud. El empleo también es limitado para los sudamericanos con trastornos mentales. Otras consecuencias, como el autoestigma, también afectan la vida de las personas con trastornos mentales en muchos contextos sudamericanos. Discusión: Las relaciones familiares, de amistad y sociales, incluidos los profesionales de la salud, pueden involucrar procesos que conducen al estigma vivido por las personas con trastornos mentales. Conclusión: Esta revisión integradora destaca cómo el estigma relacionado con el trastorno mental afecta a las personas en América del Sur.

Introdução: Pessoas com transtornos mentais são altamente estigmatizadas por populações em todo o mundo e são vistas como um fardo para a sociedade. Como resultado do estigma, muitas pessoas com transtornos mentais são discriminadas, o que leva a oportunidades de vidas limitadas. Dado que as crenças sobre o transtorno mental podem variar de acordo com a cultura, religião, nacionalidade e etnia, é importante compreender os diferentes tipos de estigma relacionados ao transtorno mental vividos em todo o mundo. Objetivos e métodos: a metodologia de Whittemore e Knafl (2005) para revisões integrativas foi usada para analisar 18 estudos sobre experiências vividas de estigma relacionado ao transtorno mental na América do Sul. Resultados: os resultados sugerem que certos tipos de estigma na América do Sul são baseados em gênero e normas sociais, como a posição social de homens e mulheres na sociedade. Isso leva à discriminação, isolamento e violência por parte da família, de parceiros íntimos, amigos, sociedade e profissionais de saúde. O emprego também é limitado para sul-americanos com transtornos mentais. Outras consequências, como o autoestigma, também afetam a vida de pessoas com transtornos mentais em muitos contextos sul-americanos. Discussão: Relações familiares, de amizade e sociais, incluindo profissionais de saúde, podem envolver processos que levam aos estigma vivenciado por pessoas com transtornos mentais. Conclusão: Esta revisão integrativa destaca como o estigma relacionado ao transtorno mental afeta os indivíduos na América do Sul.

General Beliefs About Illicit Drug Use and Stigma: Perspective of People Who Use Illicit Drugs.

People who use illicit drugs are continuously subjected to harsh stigmatization from society. This study explores the perspectives of people who use illicit drugs, specifically their general beliefs about illicit drug use and related stigma. A convergent parallel mixed methods design was used, combining quantitative and qualitative methods. The participants were recruited in a Psychosocial Care Centre (CAPSad) of a municipality in the state of Sao Paulo in Brazil. Findings revealed that illicit drug use can cause individual, family, professional and social difficulties, including problems with the law. The participants indicated they felt victimized by illicit drugs and their use, but also shared prejudicial and discriminatory views, highlighting self-stigmatizing perspectives. There is a need to develop intervention studies with a psychosocial approach on the use of illicit drugs, valuing the person's participation in the treatment, covering biomedical approaches, having in mind the social impact of illicit drugs and their use.

Health care providers and people with mental illness: An integrative review on anti-stigma interventions.

BACKGROUND: Health care providers are an important target group for anti-stigma interventions because they have the potential to convey stigmatizing attitudes towards people with mental illness. This can have a detrimental impact on the quality and effectiveness of care provided to those affected by mental illness. AIMS AND METHODS: Whittemore & Knafl's integrative review method (2005) was used to analyze 16 studies investigating anti-stigma interventions targeting health care providers. RESULTS: The interventions predominantly involved contact-based educational approaches which ranged from training on mental health (typically short-term), showing videos or films (indirect social contact) to involving people with lived experiences of mental illness (direct social contact). A few studies focused on interventions involving educational strategies without social contact, such as mental health training (courses/modules), distance learning via the Internet, lectures, discussion groups, and simulations. One study investigated an online anti-stigma awareness-raising campaign that aimed to reduce stigmatizing attitudes among health care providers. CONCLUSION: Anti-stigma interventions that involve social contact between health care providers and people with mental illness, target specific mental illnesses and include long-term follow-up strategies seem to be the most promising at reducing stigma towards mental illness among health care providers.

Alignment and contribution of nursing doctoral programs to achieve the sustainable development goals.

BACKGROUND: Different social segments from several regions of the world face challenges in order to achieve the sustainable development goals (SDGs). Nursing represents the greatest number of health workforce in the globe, dealing with these challenges in different paths, among them the training of human resources. In this context, the goal of this study was to compare the relationship between the objectives and research areas underlying nursing doctoral programs in Latin America and the SDGs. METHOD: Documental research comparing data of all Latin American nursing doctoral programs and the SDGs, conducted between January and March 2020. RESULTS: From the total of 56 existing programs in Latin America, this study analyzed 52 of them, representing 92.8% of the total. Most nursing doctoral programs have contributed to SDG 3, in addition to goals 1, 2, 4, 5, 6, 8, 9, 10, 12 and 16. The SDGs 11, 13, 14, 15 and 17 were not related to any of the analyzed programs. Data reveal that the training of nursing PhDs is essential to fulfilling these goals. Results also indicate a need of programs to remain committed to relationships that enhance nursing skills to cope with the current challenges in terms of global health, such as investments for the reduction of social and gender inequities. CONCLUSION: The doctoral training of nurses in Latin America needs to be better aligned with the sustainable development goals (SDGs), since there is a high concentration in SDG 3. We believe that nursing will bring a greater contribution to the movement to protect planetary health as the principles governing nursing practices are better aligned with international health demands and agendas.

Crianças com dificuldades alimentares apresentam um consumo excessivo de bebidas açucaradas / Children with feeding difficulties present an excessive consume of sugar-sweetened beverages

Introdução: O consumo excessivo de bebidas açucaradas na infância é uma preocupação no acompanhamento das dificuldades alimentares, visto que pode gerar inadequações do estado nutricional. Objetivo: Estimar o perfil do consumo de alimentos de consistência líquida em crianças com dificuldades alimentares atendidas em um centro especializado e, verificar a associação entre a quantidade ingerida e a contribuição energética de bebidas açucaradas e idade e índice de massa corporal por idade. Métodos: Estudo transversal com 119 crianças de 0 a 18 anos, realizado em ambulatório especializado no atendimento de dificuldades alimentares. Os dados foram coletados de prontuários e diário alimentar. Resultados: A maioria da amostra era do gênero masculino (66,1%), considerada eutrófica quanto ao IMC/idade (77,3%), com média de idade de 4,1 anos (± 3,25). Houve diferença estatisticamente significativa para ingestão total de sucos, sendo que os meninos tiveram maior média de ingestão. A média de contribuição energética tanto para o sexo masculino quanto para o feminino é maior em relação ao consumo de leite. No entanto, não houve diferenças estatisticamente significativas entre os resultados (p > 0,05). Foram encontradas correlações muito fracas ou fracas entre volume ingerido e contribuição energética de bebidas açucaradas e idade e índice de massa corporal por idade. Conclusão: Crianças com dificuldades alimentares apresentam consumo elevado de bebidas açucaradas, havendo maior ingestão de sucos por crianças do sexo masculino e o leite foi o líquido que apresentou maior contribuição energética na dieta total deles. As associações encontradas entre volume consumido e contribuição energética de bebidas, idade e índice de massa corporal são fracas ou muito fracas não correspondendo à correlação entre as mesmas.

Introduction: Excessive consumption of sugar-sweetened beverages during childhood is a problem in the follow-up of children with feeding difficulties, as it can lead to inadequate nutritional status. Objective: To estimate the food consumption profile of liquid consistency in children with feeding difficulties attended at a specialized center in order to verify consumed amount and energy contribution of sugar-sweetened beverages and age and body mass index by age. Methods: A cross-sectional study was carried out with 119 children aged 0 to 18 years at an outpatient clinic specialized in feeding difficulties. Data were collected from medical records and dietary records. Results: Most of the sample was male (66.1%) and considered eutrophic for BMI/age (77.3%), with a mean age of 4.1 years (± 3,25). There was a statistically significant difference regarding the total amount of juice intake, and boys had a higher mean intake. Mean energy intakes for both males and females are higher in relation to milk consumption. However, there were no statistically significant differences between the results (p> 0.05). Weak correlations were found between ingested volume and energy contribution of sugar-sweetened beverages and age and body mass index by age. Conclusion: Children with feeding difficulties have high consumption of sugar-sweetened beverages, with a higher juice intake by male children. Milk was the liquid that presented the highest energy contribution in their total diet. The associations found between the volume consumed and the energy contributions of beverages, age, and body mass index were weak or very weak, not corresponding to the correlation between them.

Adaptação cultural da Mental Illness: Clinicians' Attitudes Scale (MICA-4) para o português brasileiro / Cultural adaptation of Mental Illness: Clinicians' Attitudes Scale (MICA-4) to Brazilian Portuguese

O estigma dos profissionais de saúde em relação às pessoas com transtornos mentais é um fenômeno que necessita ser alvo de estudo para que sejam realizadas reflexões e construções de estratégias de intervenções anti-estigma. Um dos métodos utilizados para a investigação do fenômeno é a utilização de escalas de mensuração de estigma. Nessa perspectiva, a escala Mental Illness: Clinicians' Attitudes Scale, versão 4, MICA-4, foi utilizada em um projeto-piloto do Centre for Addiction and Mental Health da Universidade de Toronto, Canadá. Com o compromisso de reproduzir o projeto no Brasil, este estudo buscou adaptar culturamente a MICA-4 para o português brasileiro. Assim, foram realizadas as etapas do processo de adaptação cultural, sendo a primeira delas a tradução, a qual foi realizada por três tradutores. Dois dos tradutores conheciam os objetivos do estudo e o outro os desconhecia. A equipe de pesquisa analisou as três traduções e, com base nessa análise, obteve a Versão Português 4. Essa versão foi encaminhada para o Comitê de Juízes e o índice de concordância para modificações foi de 60%. Por conta desse baixo índice, a equipe de pesquisa manteve a Versão Português 4. Na etapa seguinte, Retrotradução, essa versão foi enviada para dois tradutores nativos de país de língua inglesa e que possuem bom conhecimento da língua portuguesa, originando duas versões em inglês. A equipe de pesquisa enviou para o autor a versão em inglês obtida por meio das comparações entre essas versões. O autor da MICA-4 sugeriu pequenos ajustes na referida versão, os quais não ocasionaram modificações na Versão Português 4. Após, seguiu-se com a fase do pré-teste, onde a Versão Português 4 foi aplicada em 40 profissionais de saúde de Unidades Básicas de Saúde e Unidades de Saúde da Família do município de Ribeirão Preto, Estado de São Paulo. A maioria dos participantes era do sexo feminino (87,5%), com média de idade de 45 anos e com formação como técnicos em enfermagem. Nesta fase, os profissionais de saúde sugeriram modificações em dois itens da escala (5 e 11) para melhor compreensão. A equipe de pesquisa acatou as sugestões, originando a Versão Português Final. Dessa forma, ficou demonstrado que este estudo buscou compreender de maneira profunda as considerações dos profissionais de saúde, com o objetivo de realizar rigorosamente o processo de Adaptação Cultural

The stigma of health professionals in relation to people with mental illness is a phenomenon that needs to be studied in order to reflect and construct strategies of antistigma interventions. One of the methods used to investigate the phenomenon is the use of stigma measurement scales. In this perspective, Mental Illness: Clinicians' Attitudes Scale, version 4, MICA-4, was used in a pilot project of the Centre for Addiction and Mental Health of the University of Toronto, Canada. With the commitment to reproduce the project in Brazil, this study sought to adapt MICA-4 to Brazilian Portuguese. Thus, the stages of the process of cultural adaptation, were carried out, the first being the translation, which was carried out by three translators. Two of the translators knew the aims of the study and the other did not. The research team analyzed the three translations and, based on this analysis, obtained the Portuguese Version 4. This version was sent to the Judges Committee and the concordance index for modifications was 60%. Because of this low index, the research team maintained the Portuguese Version 4. In the following stage, Back-Translation, this version was sent to two native English-speaking translators who have a good knowledge of the Portuguese language, originating two English versions. The research team sent the author the English version obtained through the comparisons between these versions. The author of MICA-4 suggested small adjustments in the version, which did not cause modifications in the Portuguese Version 4. After, it was followed with the phase of the pre-test, where Portuguese Version 4 was applied in 40 health professionals of Basic Health Units and Family Health Units in the city of Ribeirão Preto, State of São Paulo. Most of the participants were female (87.5%), mean age 45 years old and with educational background as a nursing technician. At this stage, health professionals suggested modifications to two items on the scale (5 and 11) for the better understanding. The research team accepted the suggestions, originating the Portuguese Final Version. In this way, it was demonstrated that this study sought to understand health professionals' considerations, in order to rigorously performing the process of Cultural Adaptation

O auto-estigma dos usuários de álcool e drogas ilícitas e os serviços de saúde: uma revisão integrativa da literatura / The self-stigma of alcohol and illicit drug users and health services: an integrative review of the literature / El auto-estigma de los usuarios de alcohol y drogas ilícitas y los servicios de salud: um repaso integrativa de la literatura

OBJETIVOS: identificar, analisar e sintetizar evidências científicas sobre a relação entre o estigma existente nos serviços de saúde no que se refere aos usuários de álcool e drogas ilícitas e o auto-estigma destes usuários. MÉTODO: revisão integrativa da literatura, através de cinco etapas distintas. RESULTADOS: do total de artigos encontrados nas bases de dados, 07 foram selecionados e analisados, resultando nas categorias "O estigma público nos serviços de saúde" e "A relação entre o estigma nos serviços de saúde e o auto-estigma em usuários de álcool e drogas ilícitas". CONCLUSÃO: o auto-estigma é influenciado pelo estigma público propagado, principalmente, por autoridades e por profissionais de saúde. Uma das alternativas para atenuar o cenário do auto-estigma é o apoio social.

OBJECTIVES: To identify, analyze and synthesize scientific evidence on the relationship between the stigma existing in health services regarding alcohol users and illicit drugs and the self-stigma of these users. METHOD: integrative review of the literature, through five distinct stages. RESULTS: of the total of articles found in the databases, 07 were selected and analyzed, resulting in the categories "Public stigma in health services" and "The relationship between stigma in health services and self-stigma in alcohol users and illicit drugs. " CONCLUSION: self-stigma is influenced by public stigma propagated, mainly by authorities and health professionals. One of the alternatives to attenuate the scenario of self-stigma is social support.

OBJETIVOS: identificar, analizar y sintetizar evidencias científicas sobre la relación entre el estigma existente en los servicios de salud en el que se refiere a los usuarios de alcohol y drogas ilícitas y el auto-estigma de estos usuarios. MÉTODO: revisión integrativa de la literatura, por medio de cinco etapas distinguidas. RESULTADOS: del total de artículos encontrados en las bases de datos, 07 fueron seleccionados y analizados, resultando en las categorias "El estigma público en los servicios de salud" y "La relación entre el estigma en los servicios de salud y el auto-estigma em usuarios de alcohol y drogas ilícitas". CONCLUSIÓN: el auto-estigma es influenciado por el estigma público propagado, principalmente, por autoridades y por profesionales de salud. Una de las alternativas para atenuar el escenario del auto-estigma es el apoyo social.

shRNA-Based Screen Identifies Endocytic Recycling Pathway Components That Act as Genetic Modifiers of Alpha-Synuclein Aggregation, Secretion and Toxicity.

Alpha-Synuclein (aSyn) misfolding and aggregation is common in several neurodegenerative diseases, including Parkinson's disease and dementia with Lewy bodies, which are known as synucleinopathies. Accumulating evidence suggests that secretion and cell-to-cell trafficking of pathological forms of aSyn may explain the typical patterns of disease progression. However, the molecular mechanisms controlling aSyn aggregation and spreading of pathology are still elusive. In order to obtain unbiased information about the molecular regulators of aSyn oligomerization, we performed a microscopy-based large-scale RNAi screen in living cells. Interestingly, we identified nine Rab GTPase and kinase genes that modulated aSyn aggregation, toxicity and levels. From those, Rab8b, Rab11a, Rab13 and Slp5 were able to promote the clearance of aSyn inclusions and rescue aSyn induced toxicity. Furthermore, we found that endocytic recycling and secretion of aSyn was enhanced upon Rab11a and Rab13 expression in cells accumulating aSyn inclusions. Overall, our study resulted in the identification of new molecular players involved in the aggregation, toxicity, and secretion of aSyn, opening novel avenues for our understanding of the molecular basis of synucleinopathies.

Saúde do pré-escolar: uma experiência de educação alimentar e nutricional como método de intervenção / Preschool health: an experience of food and nutrition education as intervention method

Buscar um melhor estado nutricional com menor risco para o desenvolvimento de doenças crônicas ao longo da vida tornou-se o novo desafio. Observa-se que creches e escolas figuram-se como ambientes favoráveis para o desenvolvimento de estratégias pedagógicas em torno da alimentação, pois, além de atenderem aos alunos, podem envolver a família e a comunidade. Logo, o presente trabalho teve como finalidade relatar a experiência com a aplicação de métodos lúdico-pedagógicos em Educação Alimentar e Nutricional (EAN) para pré-escolares. Trata-se de um relato acerca de experiências educativas realizadas entre setembro de 2011 e junho de 2013, com direcionamento para crianças de 2 a 5 anos de idade, matriculadas em uma organização social pública não estatal do município de Juiz de Fora (MG). Mensalmente eram realizados 4 encontros com cada uma das turmas contempladas pelo projeto. Nas atividades, eram transmitidas informações dinâmicas e lúdicas sobre a importância do consumo de alimentos saudáveis. Em todos os encontros, os alunos manifestaram grande interesse em expressar suas vontades, hábitos, experiências e preferências alimentares, interagindo espontaneamente, por meio das exposições de suas vivências e de questionamentos frequentes. As atividades possibilitaram a construção de saberes a respeito das escolhas alimentares e subsidiaram experiências de aprendizado que podem ser duradouras. É fundamental associar medidas de incentivo, estratégias de transmissão de informações e práticas de EAN, buscando concretizar a promoção de hábitos saudáveis e contribuir para a prevenção de prejuízos para a saúde.

Seek a better nutritional status and lower risk of developing chronic diseases throughout life has become the new challenge. It is observed that kindergartens and schools constitute as favorable environments for the development of teaching strategies around the food, as well as meet students can involve the family and the community. Therefore, this study aimed to report the experience with the use of recreational and teaching methods in Food and Nutrition Education (FNE) for preschoolers. It is a story about educational experiences carried out between September 2011 and June 2013 with guidance for children 2-5 years old, enrolled in a public nonstate social organization of Juiz de Fora city (MG). Monthly meetings were held 4 with each of the classes covered by the project. The activities were transmitted dynamic and entertaining information about the importance of consuming healthy foods. In all meetings the students expressed great interest in expressing their desires, habits, food preferences and experiences spontaneously interacting through exhibitions of their experiences and asked questions. The activities made possible the construction of knowledge about the food choices and subsidized learning experiences that can be lasting. It is essential to associate incentives, information transmission strategies and FNE practices, seeking to achieve the promotion of healthy habits and contribute to the prevention of damage to health.

Morte e luto: competências dos profissionais / Death and mourning: skills of professionals

A concepção social de morte é resultado de um longo processo histórico, marcado por diferentes sistemas econômicos e sociais, bem como por costumes que envolvem dimensões existenciais, subjetivas e espirituais. Este artigo tem como objetivo revisar a morte, o luto e as competências profissionais nos diversos contextos. A metodologia adotada consiste na revisão bibliográfica de artigos pesquisados nas bases de dados PubMed, Scielo.org, BVS Psi, EBSCO, LILACS, PePSIC, PsycNET, Science Direct e Web of Knowledge (ISI), no período de 2008 a 2014, por meio de termos como morte, luto e profissionais, incluindo o ciclo da vida (crianças, adolescentes, adultos e idosos). Conclui-se que há deficiência na formação educacional dos profissionais que lidam com a morte e o luto, sobretudo aqueles que trabalham em contextos de saúde. Observou-se a necessidade da criação de programas voltados à educação para a morte nos currículos dos profissionais e na sociedade de maneira geral, incluindo medidas interventivas e protocolos em terapia cognitivo-comportamental para adquirir competências no enfrentamento adequado e saudável dessas experiências(AU)

The social concept of death is the result of a long historical process, marked by different economic, social and customs systems that also involve existential, subjective and spiritual dimensions. This article aims to review death and mourning and professional skills in various contexts. The methodology of this work consists of a literature review of articles found in the databases PubMed, Scielo.org, BVS Psi, EBSCO, LILACS, PePSIC, PsycNET, Science Direct and Web of Knowledge (ISI), during the period of 2008 to 2014, using the search terms death, mourning and professionals, including the life cycle (children, adolescents, adults and elderly). It was concluded that there is deficiency in the educational training of professionals who deal with death and grief, especially those working in health contexts. The need to create educational programs discussing death was observed in the curricula of professionals and society in general, including interventional measures and protocols in cognitive-behavioral therapy to acquire skills in proper and healthy coping with these experiences(AU)

Potent anti-inflammatory and antiproliferative effects of gambogic acid in a rat model of antigen-induced arthritis.

BACKGROUND: We have previously reported a continuous activation of caspase-1 and increased interleukin (IL)-1ß levels in early rheumatoid arthritis (RA). These observations raised the hypothesis that drugs targeting the IL-1ß pathway, in addition to tumour necrosis factor (TNF), may be particularly effective for early RA treatment. We have recently identified gambogic acid as a promising therapeutic candidate to simultaneously block IL-1ß and TNF secretion. Our main goal here was to investigate whether gambogic acid administration was able to attenuate inflammation in antigen-induced arthritis (AIA) rats. METHODS: Gambogic acid was administered to AIA rats in the early and late phases of arthritis. The inflammatory score, ankle perimeter, and body weight were evaluated during the period of treatment. Rats were sacrificed after 19 days of disease progression and paw samples were collected for histological and immunohistochemical evaluation. RESULTS: We found that inflammation in joints was significantly suppressed following gambogic acid administration. Histological and immunohistochemical evaluation of treated rats revealed normal joint structures with complete abrogation of the inflammatory infiltrate and cellular proliferation. CONCLUSIONS: Our results suggest that gambogic acid has significant anti-inflammatory properties and can possibly constitute a prototype anti-inflammatory drug with therapeutic efficacy in the treatment of inflammatory diseases such as RA.

Anthracyclines induce DNA damage response-mediated protection against severe sepsis.

Severe sepsis remains a poorly understood systemic inflammatory condition with high mortality rates and limited therapeutic options in addition to organ support measures. Here we show that the clinically approved group of anthracyclines acts therapeutically at a low dose regimen to confer robust protection against severe sepsis in mice. This salutary effect is strictly dependent on the activation of DNA damage response and autophagy pathways in the lung, as demonstrated by deletion of the ataxia telangiectasia mutated (Atm) or the autophagy-related protein 7 (Atg7) specifically in this organ. The protective effect of anthracyclines occurs irrespectively of pathogen burden, conferring disease tolerance to severe sepsis. These findings demonstrate that DNA damage responses, including the ATM and Fanconi Anemia pathways, are important modulators of immune responses and might be exploited to confer protection to inflammation-driven conditions, including severe sepsis.

Highly dynamic host actin reorganization around developing Plasmodium inside hepatocytes.

Plasmodium sporozoites are transmitted by Anopheles mosquitoes and infect hepatocytes, where a single sporozoite replicates into thousands of merozoites inside a parasitophorous vacuole. The nature of the Plasmodium-host cell interface, as well as the interactions occurring between these two organisms, remains largely unknown. Here we show that highly dynamic hepatocyte actin reorganization events occur around developing Plasmodium berghei parasites inside human hepatoma cells. Actin reorganization is most prominent between 10 to 16 hours post infection and depends on the actin severing and capping protein, gelsolin. Live cell imaging studies also suggest that the hepatocyte cytoskeleton may contribute to parasite elimination during Plasmodium development in the liver.

Substituição parcial de farelo de soja por uréia na alimentação de vacas Girolanda em lactação / Parcial replacement of soy bean meal by urea on Girolanda lactation cows ration

Objetivo - Comparar a substituição parcial de farelo de soja por uréia sobre a produtividade e qualidade do leite. Métodos - Foram utilizadas 24 vacas Girolanda em lactação em um experimento com delineamento inteiramente casualizado. Dois concentrados foram utilizados: (C) controle, sendo a principal fonte de proteína o farelo de soja e (U) uréia, neste tratamento 1/3 da proteína total foi substituída por nitrogênio não protéico (NNP) oriundo da uréia. Foram avaliadas a produção, a composição e as características físico-químicas do leite. As dietas foram formuladas seguindo as recomendações do NRC (2001) e a nutrição protéica foi acompanhada pela concentração de uréia plasmática. A contagem de células somáticas foi utilizada com a finalidade de monitorar a sanidade da glândula mamária. Resultados - A produção leiteira foi diferente (P<0,05) entre os tratamentos 9,41 para o grupo Uréia vs. 7,98 kg/vaca/dia para o grupo Controle. A composição e as características físico-químicas foram semelhantes entre os tratamentos (P>0,05). Houve redução de 11,5% no custo do concentrado com inclusão de uréia. Conclusão - A substituição parcial do farelo de soja por uréia em dietas para vacas Girolanda mostrou-se uma alternativa viável para a produção leiteira, pois além de aumentar a produção, reduziu os custos com alimentação, sem alterar o valor nutricional do leite.

Objective - To compare the partially replacement of soybean meal by urea on lactation performance in experiment completely randomized. Methods - Twenty four Girolanda dairy cows were used. Two treatments were used: (C) control, being the main source of protein soybean meal and (U) urea, in this treatment 1/3 of total protein was replaced by non-protein nitrogen (NPN) derived from the urea. Milk production, composition and physico-chemical characteristic were measured. Diets were formulated following the recommendations of NRC (2001) and protein diet was accompanied by the concentration of blood urea nitrogen. Somatic cell count was used to monitor udder health. Results - There were differences (P>0.05) among treatments only for milk production 9.41 for urea treatment vs. 7.98 kg/cow/day for control treatment. Milk composition and physico-quimical characteristics were similar among treatments (P>0.05). There was a decrease of 11,5% in the cost of the concentrate with addition of urea. Conclusion - This study indicated that using urea for lactating Girolanda dairy cows had no detrimental effect on lactation performance or on milk nutritional value.

An shRNA-based screen of splicing regulators identifies SFRS3 as a negative regulator of IL-1ß secretion.

The generation of diversity and plasticity of transcriptional programs are key components of effective vertebrate immune responses. The role of Alternative Splicing has been recognized, but it is underappreciated and poorly understood as a critical mechanism for the regulation and fine-tuning of physiological immune responses. Here we report the generation of loss-of-function phenotypes for a large collection of genes known or predicted to be involved in the splicing reaction and the identification of 19 novel regulators of IL-1ß secretion in response to E. coli challenge of THP-1 cells. Twelve of these genes are required for IL-1ß secretion, while seven are negative regulators of this process. Silencing of SFRS3 increased IL-1ß secretion due to elevation of IL-1ß and caspase-1 mRNA in addition to active caspase-1 levels. This study points to the relevance of splicing in the regulation of auto-inflammatory diseases.