Quais são as barreiras e facilitadores para a participação de pessoas com Síndrome de Down? Uma Revisão de Escopo.

OBJETIVO: Determinar as barreiras e facilitadores da participação ativa na comunidade de crianças, adolescentes e adultos com Síndrome de Down (SD). Métodos: Foram realizadas buscas em cinco bases de dados eletrônicas para identificar estudos originais sobre a participação de crianças, adolescentes (idades <18 anos) e adultos (idades de 18 a 59 anos) com SD. Barreiras e facilitadores para a participação foram categorizados em fatores: pessoais, sociais, ambientais e de políticas e programas. Os achados foram analisados e validados por um jovem adulto com SD e um membro da família, utilizando a estratégia de Envolvimento do Público e Paciente. RESULTADOS: Quatorze estudos foram incluídos, oito com crianças e adolescentes e seis com adultos. Dos 14 estudos, dez eram qualitativos e quatro quantitativos. A maioria dos estudos (n = 9) investigou a participação em atividades físicas, enquanto apenas alguns estudos examinaram a participação em atividades comunitárias/sociais (n = 3), atividades diárias (n = 2) e atividades de lazer (n = 1). As barreiras e facilitadores mais frequentemente citados foram a disponibilidade de programas e profissionais especializados, transporte, bem como atitudes e comportamentos. As características físicas e psicológicas das pessoas com SD e as instalações também foram frequentemente mencionadas como barreiras. Por outro lado, o desejo de se manter ativo e o interesse pessoal na atividade estavam entre os facilitadores mais frequentemente relatados. INTERPRETAÇÃO: A participação de pessoas com SD é principalmente influenciada por fatores físicos ou psicológicos, o apoio e as atitudes dos pais/cuidadores e a disponibilidade de programas especializados. Dada a escassez de pesquisas investigando a participação de pessoas com SD em atividades comunitárias, atividades diárias e lazer, especialmente em adultos, mais estudos ainda são necessários.

What are the barriers and facilitators to participation of people with Down syndrome? A scoping review.

AIM: To determine the barriers and facilitators of active community participation of children, adolescents, and adults with Down syndrome. METHOD: Searches were completed in five electronic databases to identify original studies about participation of children, adolescents (ages < 18 years), and adults (ages 18-59 years) with Down syndrome. Barriers and facilitators to participation were categorized into four factors: personal, social, environmental, and policy and programme. Findings were analysed and validated by a young adult with Down syndrome and a family member, using the public and patient involvement strategy. RESULTS: Fourteen studies were included: eight with children and adolescents and six with adults. Of the 14 studies, 10 were qualitative and four quantitative. Most studies (n = 9) investigated participation in physical activities, while only a few examined participation in community/social activities (n = 3), daily activities (n = 2), and leisure activities (n = 1). The most commonly cited barriers and facilitators were the availability of programmes and specialized professionals, transportation, as well as attitudes and behaviours. Physical and psychological characteristics of people with Down syndrome and facilities were also frequently mentioned as barriers. On the other hand, the desire to stay active and personal interest in the activity were among the most frequently reported facilitators. INTERPRETATION: The participation of people with Down syndrome is mainly influenced by physical or psychological factors, the support and attitudes of parents/caregivers, and the availability of specialized programmes. Given the scarcity of research investigating the participation of people with Down syndrome in community activities, daily activities, and leisure, especially in adults, more studies are still needed.

Gut microbiome predicts gastrointestinal toxicity outcomes from chemoradiation therapy in patients with head and neck squamous cell carcinoma.

OBJECTIVES: Chemoradiation (CRT) in patients with locally advanced head and neck squamous cell cancer (HNSCC) is associated with significant toxicities, including mucositis. The gut microbiome represents an emerging hallmark of cancer and a potentially important biomarker for CRT-related adverse events. This prospective study investigated the association between the gut microbiome composition and CRT-related toxicities in patients with HNSCC, including mucositis. MATERIALS AND METHODS: Stool samples from patients diagnosed with locally advanced HNSCC were prospectively collected prior to CRT initiation and analyzed using shotgun metagenomic sequencing to evaluate gut microbiome composition at baseline. Concurrently, clinicopathologic data, survival outcomes and the incidence and grading of CRT-emergent adverse events were documented in all patients. RESULTS: A total of 52 patients were included, of whom 47 had baseline stool samples available for metagenomic analysis. Median age was 62, 83 % patients were men and 54 % had stage III-IV disease. All patients developed CRT-induced mucositis, including 42 % with severe events (i.e. CTCAE v5.0 grade ≥ 3) and 25 % who required enteral feeding. With a median follow-up of 26.5 months, patients with severe mucositis had shorter overall survival (HR = 3.3, 95 %CI 1.0-10.6; p = 0.02) and numerically shorter progression-free survival (HR = 2.8, 95 %CI, 0.8-9.6; p = 0.09). The gut microbiome beta-diversity of patients with severe mucositis differed from patients with grades 1-2 mucositis (p = 0.04), with enrichment in Mediterraneibacter (Ruminococcus gnavus) and Clostridiaceae family members, including Hungatella hathewayi. Grade 1-2 mucositis was associated with enrichment in Eubacterium rectale, Alistipes putredinis and Ruminococcaceae family members. Similar bacterial profiles were observed in patients who required enteral feeding. CONCLUSION: Patients who developed severe mucositis had decreased survival and enrichment in specific bacteria associated with mucosal inflammation. Interestingly, these same bacteria have been linked to immune checkpoint inhibitor resistance.

An innovative multi-enzymatic system for gluconic acid production from starch using Aspergillus niger whole-cells.

The use of multi-enzymatic systems for the industrial production of chemical compounds is currently considered an important green tool in synthetic organic chemistry. Gluconic acid is a multi-functional organic acid widely used in the chemical, pharmaceutical, food, textile, and construction industries. Its industrial production from glucose by fermentation using Aspergillus niger has drawbacks including high costs related to cell growth and maintenance of cell viability. This study presents an innovative one-step multi-enzymatic system for gluconic acid production from starch using Aspergillus niger whole-cells in association with amylolytic enzymes. Using soluble starch as substrate, the following results were achieved for 96 h of reaction: 134.5 ± 4.3 g/L gluconic acid concentration, 98.2 ± 1.3 % gluconic acid yield, and 44.8 ± 1.4 gGA/gwhole-cells biocatalyst yield. Although the process has been developed using starch as raw material, the approach is feasible for any substrate or residue that can be hydrolyzed to glucose.

Lifestyle changes during the COVID-19 pandemic in Brazil: results from three consecutive cross-sectional web surveys.

OBJECTIVE: The importance of a healthy lifestyle in preventing morbidity and mortality is well-established. The COVID-19 pandemic brought about significant lifestyle changes globally, but the extent of these changes in the Brazilian population remains unclear. The objective of this study was to evaluate changes in lifestyle among the Brazilian general population during the first year of the pandemic. DESIGN: Three consecutive anonymous web surveys were carried out: survey 1 (S1)-April 2020, S2-August 2020 and S3-January 2021. SETTING: Brazil. PARTICIPANTS: The study included 19 257 (S1), 1590 (S2) and 859 (S3) participants from the general population, who were ≥18 years, of both sexes, with access to the internet, self-reporting living in Brazil and who agreed to participate after reading the informed consent. PRIMARY OUTCOME: Lifestyle changes were assessed using the Short Multidimensional Instrument for Lifestyle Evaluation-Confinement (SMILE-C). The SMILE-C assesses lifestyle across multiple domains including diet, substance use, physical activity, stress management, restorative sleep, social support and environmental exposures. We used a combination of bootstrapping and linear fixed-effect modelling to estimate pairwise mean differences of SMILE-C scores overall and by domain between surveys. RESULTS: In all the surveys, participants were mostly women and with a high education level. Mean SMILE-C scores were 186.4 (S1), 187.4 (S2) and 190.5 (S3), indicating a better lifestyle in S3 as compared with S1. The pairwise mean differences of the overall SMILE-C scores were statistically significant (p<0.001). We also observed a better lifestyle over time in all domains except for diet and social support. CONCLUSIONS: Our findings indicate that individuals from a large middle-income country, such as Brazil, struggled to restore diet and social relationships after 1 year of the pandemic. These findings have implications for monitoring the long-term consequences of the pandemic, as well as future pandemics.

Red biocolorant from endophytic Talaromyces minnesotensis: production, properties, and potential applications.

Fungal colorants are gradually entering the global color market, given their advantages of being less harmful to human health, as well as having greater stability and biotechnological potential, compared to other natural sources. The present work concerns the isolation and identification of an endophytic filamentous fungus, together with the chemical characterization and assessment of the fluorescence, toxicity, stability, and application potential of its synthesized red colorant. The endophytic fungus was isolated from Hymenaea courbaril, a tree from the Brazilian savannah, and was identified as Talaromyces minnesotensis by phenotypic and genotypic characterization. Submerged cultivation of the fungus resulted in the production of approximately 12 AU500 of a red biocolorant which according to LC-DAD-MS analysis is characterized by being a complex mixture of molecules of the azaphilone class. Regarding cytotoxicity assays, activity against human hepatoblastoma (HepG2) cells was only observed at concentrations above 5.0 g L-1, while antimicrobial effects against pathogenic bacteria and yeast occurred at concentrations above 50.0 g L-1. The biocolorant showed high stability at neutral pH values and low temperatures (10 to 20 °C) and high half-life values (t1/2), which indicates potential versatility for application in different matrices, as observed in tests using detergent, gelatin, enamel, paint, and fabrics. The results demonstrated that the biocolorant synthesized by Talaromyces minnesotensis has potential for future biotechnological applications. KEY POINTS: • An endophytic fungus, which was isolated and identified, synthesize a red colorant. • The colorant showed fluorescence property, low toxicity, and application potential. • The red biocolorant was highly stable at pH 8.0 and temperatures below 20°C.

The mediating role of unmet needs in the relationship between displacement and psychological adjustment: A study of cancer survivors from a Portuguese island region.

PURPOSE: The present study aims to explore whether the association between previous displacement to mainland Portugal to perform cancer therapy and current psychological adaptation is mediated by cancer survivors' unmet needs in terms of their emotional experience, financial concerns, access and continuity of care, and relations with others. METHOD: This cross-sectional study included a sample of 173 cancer survivors from the Azores archipelago (Portugal) recruited from a local oncological health unit. Participants completed a sociodemographic and clinical questionnaire and self-report measures assessing their unmet needs and psychological adaptation. Two parallel multiple mediation models were tested. RESULTS: Azorean cancer survivors live with unmet needs, especially emotional needs (M = 16.68, SD = 10.78). Displacement was indirectly associated with both anxious (indirect effect = 0.58, SE = 0.27, 95% Bias Corrected and accelerated Confidence Interval = [0.05, 1.15]) and depressive symptomatology (indirect effect = 0.36, SE = 0.17, 95% Bias Corrected and accelerated Confidence Interval = [0.03, 0.84]) through unmet emotional needs. CONCLUSION: Previous displacements seem to play an important role in the way cancer survivors adapt to survivorship by contributing to higher levels of unmet emotional needs. These findings can provide a scientific and clinical contribution to other isolated or island regions in the world where survivors face similar constraints.

Estudo de aceitabilidade das intervenções psicológicas via telefone para sobreviventes de cancro dos Açores / Azorean cancer survivors' acceptability of psychological telephone-based interventions

INTRODUÇÃO: As intervenções com recurso à tecnologia têm mostrado ser promissoras para ultrapassar algumas barreiras de acesso aos cuidados dos sobreviventes de cancro de regiões mais isoladas. Os estudos de aceitabilidade e das preferências dos sobreviventes relativamente a estas intervenções são escassos em Portugal e inexistentes nos Açores. OBJETIVOS: Este estudo pretendeu avaliar: i) os comportamentos de procura de ajuda dos sobreviventes de cancro dos Açores e as barreiras à procura de ajuda; e ii) o grau de aceitabilidade e as preferências destes sobreviventes relativamente ao desenvolvimento, implementação e participação numa intervenção psicológica via telefone. MÉTODO: Este estudo envolveu 173 sobreviventes de cancro dos Açores, recrutados num hospital público regional, numa unidade de saúde regional e numa instituição sem fins lucrativos. Recorreu-se a um questionário construído para o efeito, sendo os dados tratados com estatística descritiva. RESULTADOS: O apoio psicológico mostrou-se um comportamento de ajuda aceitável para os sobreviventes, sendo as barreiras à procura de ajuda de índole estrutural/prática e de conhecimento as mais endossadas pelos participantes. A maioria da amostra considerou útil uma intervenção psicológica via telefone, reportando ser provável participar. As sessões com uma duração situada entre os 30 a 45 minutos e com uma periodicidade quinzenal foram os aspetos preferenciais dos participantes. DISCUSSÃO E CONCLUSÃO: Espera-se que os resultados deste estudo possam orientar o desenvolvimento de uma intervenção via telefone que responda flexivelmente às necessidades dos sobreviventes dos Açores e facilite o suporte a prestar-lhes, integrando as suas preferências no desenho de uma intervenção desta natureza.

INTRODUCTION: Technology-based interventions are promising for overcoming some barriers that cancer survivors from isolated regions face in accessing health-care. No studies are exploring the acceptability and preferences concerning these interventions in Portugal and even in the Azores. OBJECTIVES: This study aims to evaluate: i) Azorean cancer survivors' help-seeking behaviors and barriers for seeking help; and ii) survivors' acceptability and preferences concerning development, implementation, and participation in the psychological telephone-based intervention. METHOD: This study included a sample of 173 cancer survivors from the Azores archipelago (Portugal) recruited from a local oncological hospital and health unit. Data were collected through a questionnaire built for this purpose and analyzed with a descriptive statistic. RESULTS: Psychological support was an accepted help-seeking behavior and the structural/practical and knowledge barriers for seeking help were the more endorsed by participants. The majority of the sample considered a psychological telephone-based intervention useful; reporting being likely participating. The length of the sessions ranging from 30 to 45 minutes and fortnightly were the participants' preferences. DISCUSSION AND CONCLUSION: Results may guide the development of a psychological telephone-based intervention for cancer survivors from the Azores, which can respond flexibly to their needs and facilitating the support to provide them, including their preferences when designing an intervention of that nature.

Non-fermented Dairy Desserts with Potentially Probiotic Autochthonous Lactobacilli and Products from Peel of Jabuticaba (Myrciaria cauliflora).

The influence of two autochthonous lactobacilli strains with probiotic potential (Lactobacillus mucosae CNPC007 and Lactobacillus plantarum CNPC020) in comparison to a commercially available probiotic strain (Lactobacillus rhamnosus LR32) in non-fermented dairy desserts added with ingredients (syrup and hydroethanolic extract) derived from jabuticaba (Myrciaria cauliflora) peels was investigated. L. mucosae showed the best survivability and stability of the studied lactobacilli after processing and during storage, respectively, and also remarkably influenced the texture and sensory features of desserts in comparison to the other strains; L. plantarum achieved viability comparable with the commercial probiotic, above 6 log cfu/g up to the 21st day of the products refrigerated storage. The hydroethanolic extract and syrup from the jabuticaba peel contributed to the phenolic content of the dairy desserts (around 30 mg GAE/100 g) that showed to be able to scavenge DPPH radicals (around 300 g dessert/g DPPH). The different lactobacilli strains did not significantly influence the antioxidant capacity parameters of the desserts (p > 0.05), although the desserts' color was not stable during storage and tended to reduce the acceptability scores of the three trials. Non-fermented dairy desserts with jabuticaba peel ingredients showed to be good sources of phenolic compounds with an antioxidant capacity, offering suitable conditions for the viability maintenance of the autochthonous lactobacilli cultures.

Práticas de integração ensino-serviço comunidade: demandas e reformulação do currículo médico / Integration practical of community-teaching-service: demands and medical curriculum reformulation

A participação coordenada das instituições de educação médica com o Sistema Único de Saúde, por meio das diretrizes e dos programas desenvolvidos por este, é fundamental para possibilitar o desenvolvimento de habilidades profissionais que valorizem o sujeito. Objetivo: Analisar as Práticas de Integração Ensino-Serviço Comunidade (PIESC) na reestruturação da formação médica, por meio de uma revisão de literatura. Métodos: Para análise desse fato, os descritores "Práticas de Integração Ensino-Serviço Comunidade" e "Atenção Primária" foram usados para pesquisa na Biblioteca Virtual em Saúde, com isso encontraram-se 21 artigos, dos quais 12 foram selecionados, pois descrevem a implementação e a importância das práticas, assim como seus obstáculos. Resultados: As principais abordagens dessa disciplina perpassam: a percepção do estudante; os obstáculos, a inserção e a implementação desta; os impactos do GraduaSUS. Discussão: Nota-se a necessidade de adaptação do currículo das escolas médicas, com o objetivo de adequar a formação profissional à Estratégia da Saúde da Família, a qual se resulta do fortalecimento da Atenção Primária à Saúde, fruto das demandas sociais contemporâneas. Conclusão: A disciplina Práticas de Integração Ensino-Serviço Comunidade torna-se ferramenta preponderante à transformação e ao emprego das matrizes curriculares dessa graduação em âmbito nacional

The coordinated participation of medical education institutions with the Unified Health System, through guidelines and programs applied by it, is fundamental to enable the development of professional skills that value the subject. Objective: Analyze the Practices of Teaching-Service Community Integration (PCTSI) in the medical formation restructuration, through a literature review. Method: To analyze this fact, the descriptors "Practices of Teaching-Service Community Integration" and "Primary Health Care" were used for research in the Biblioteca Virtual em Saúde, thus 21 articles were found, from which 12 were selected, because they describe the implementation and the significance of the practices, as well as their obstacles. Results: The main approaches of this discipline run through: the student's perception; the obstacles, its insertion and implementation; the impacts of GraduaSUS. Discussion: Note that it is necessary to adjust the curriculum of medical schools, with the objective of adapting professional training to the Family Health Strategy, that results of strengthening Primary Health Care, the fruit of contemporary social demands. Conclusion: The discipline Practices of Teaching-Service Community Integration of Medicine becomes a preponderant tool for the transformation and the use of the curricular matrices of this graduation nationally

[Frequent Users of the Pediatric Emergency Department: To Know, To Intervene and To Evaluate - A Pilot Study]. / Utilizadores Frequentes da Urgência Pediátrica: Conhecer, Intervir e Analisar - Um Estudo Piloto.

INTRODUCTION: Frequent users contribute to an excessive volume of admissions in the emergency department, impairing the quality of healthcare services. The aim of this study was to identify and characterize the population of frequent users of the pediatric emergency department, establish an individual plan of intervention and evaluate its efficacy. MATERIAL AND METHODS: Intervention study including children and adolescents younger than 16 years, with more than 10 visits in a year to an emergency department of a secondary care hospital. An intervention program was created with a multidisciplinary team and a case manager, who was responsible for the execution of the individual plan of intervention. One year later, the number of visits after the intervention was assessed. RESULTS: We identified 90 patients with a frequent user profile, with 1182 visits. Only 17.3% of the visits had a previous referral. Most of the visits were considered non urgent/less urgent (59%). The intervention included 82 children/adolescents. One year later, there was a significant reduction in the number of visits: median reduction of 62% in 78 participants. DISCUSSION: Most of the visits by frequent users were considered non urgent/less urgent, reflecting a clinically unjustified use of the emergency department. The intervention seems to be effective as the number of visits decreased. CONCLUSION: This population of frequent users seems to be a heterogeneous group with different problems and levels of complexity. A multidisciplinary and individual intervention, with a case manager, might contribute to reduce the excessive use of the emergency department and improve the provision of health care services to these children.

Introdução: Os utilizadores frequentes contribuem para um volume excessivo de admissões no serviço de urgência, prejudicando a qualidade dos serviços prestados. O objetivo deste estudo foi identificar e caracterizar os utilizadores frequentes da urgência pediátrica, traçar um plano de intervenção e avaliar a sua eficácia.Material e Métodos: Estudo de intervenção, incluindo crianças e adolescentes menores de 16 anos, com mais de 10 admissões num ano na urgência pediátrica de um hospital de nível II. Foi criado um modelo de intervenção com uma equipa multidisciplinar e um gestor de caso, responsável pela execução do plano de intervenção individualizado. Após um ano de intervenção foi avaliada a evolução do número de admissões.Resultados: Identificámos 90 utentes com o perfil de utilizador frequente, com 1182 admissões. Apenas 17,3% das admissões eram referenciadas. A maioria das admissões foi considerada não urgente/pouco urgente (59%). Foram incluídas na intervenção 82 crianças/adolescentes. Após um ano de intervenção verificou-se uma diminuição significativa do número de admissões, com uma redução média de 62% em 78 participantes.Discussão: A maioria das admissões dos utilizadores frequentes foi considerada não urgente/pouco urgente, evidenciando a ausência de indicação clínica para observação hospitalar. Os resultados da intervenção parecem ser favoráveis, com uma redução do número de admissões.Conclusão: Esta população de utilizadores frequentes da urgência pediátrica constitui um grupo heterogéneo, com problemas de complexidade variável. Um modelo de intervenção multidisciplinar e individualizado, com um gestor de caso pode contribuir para reduzir o recurso excessivo à urgência e melhorar a prestação de cuidados de saúde a estas crianças.

A reconstrução da autonomia do adulto jovem após um acidente vascular cerebral gerador de dependência no autocuidado / The reconstruction of young adult ́s autonomy after a stroke generating dependence on self-care

O acidente vascular cerebral (AVC) encontra-se nos primeiros lugares da lista de causas de morte a nível mundial, sendo uma causa major de incapacidade funcional no adulto. Nos últimos anos tem-se observado um aumento significativo na incidência desta patologia nas pessoas mais jovens acompanhado pelo o aumento da incapacidade física, com repercussões ao nível na execução do autocuidado. Vivenciar uma transição saúde-doença, acarreta alterações profundas na vida de quem experimenta um processo desta natureza, nomeadamente quando se trata de um adulto jovem. Foi realizado um estudo qualitativo de carácter exploratório e descritivo, tendo como objetivos, explorar, descrever e compreender a perspetiva do adulto jovem sobre o processo de reconstrução da sua autonomia após um AVC gerador de dependência no autocuidado. Optou-se pela entrevista não estruturada, dirigida a seis (N= 6) adultos jovens sobreviventes de AVC. A análise das narrativas das entrevistas foi realizada com recurso à análise de conteúdo. Desta emergiram nove (9) categorias: pontos e eventos críticos; alterações na condição de saúde; consciencialização; envolvimento; condições facilitadoras pessoais e sociais; condições inibidoras pessoais e sociais; indicadores de processo; indicadores de resultado; e cuidados informais. Os resultados sugerem que este percurso se inicia com o evento crítico, o AVC, responsável por mudanças na condição de saúde dos participantes, principalmente ao nível do desempenho do autocuidado. A sua recuperação pressupõe envolvimento, o qual acontece quando existe consciencialização das mudanças. A vivência da transição está rodeada por um conjunto de fatores que podem facilitar ou obstaculizar este percurso. É possível ainda inferir a existência de indicadores de processo relacionados com a ligação dos participantes aos profissionais de saúde e com estratégias de adaptação à nova situação, bem como, a existência de indicadores de resultados, os quais reportam fundamentalmente à mestria e o retorno à vida social. Sendo cada percurso vivenciado individualmente, os enfermeiros devem ajustar as suas práticas recorrendo às terapêuticas de enfermagem revelando-se verdadeiros facilitadores da transição saúde-doença vivida por cada sobrevivente do AVC em geral, e em particular pelo adulto jovem.

The stroke stands in the frontline regarding the list of the world death causes, being itself a major cause of adult functional incapacity. Lately, we have been watching a significant increase in the incidence of this pathology in younger adults followed by a physical incapacity rise, with consequences in terms of the self-care. To undergo a health-disease transition provides profound modifications viewing the life of those who experience such a process of this nature, particularly when it comes to a young adult life. A descriptive, qualitative, and exploratory study has been conducted, which goals pretend to explore, describe and understand the young adult perspective about the autonomy reconstruction process after a self-care dependency triggering stroke. The non structured interview was selected and forwarded to six (6) young adults, who have survived after a stroke. The analysis of the interviews was performed through content analysis. From this last one, nine (9) categories have emerged: points and critical events; health condition alterations; awareness; engagement; personal and social facilitating conditions; personal and social inhibiting conditions; process indicators; outcome indicators and informal care. The results sugest that this pathway begins with a critical event, the stroke, responsible for the modifications in participants` health condition, mostly referring to the self-care performance. Its recovery assumes engagement, which happens when there is awareness of the changes. The living process of the transition is surrounded by a group of factors that might ease up or handicap all this course. Still, it is possible to imply the connection between the participants and the health professionals and with the adaption strategies to the new situation, as well as the existence of result indicators, which basically apply to the social life and mastery. Since each journey is individually experienced, the nurses should adjust their pratice based on the Nursing healing theurapeutics becoming real facilitatiors of the health-disease transition perceived by each stroke survivor, in general, and, in particular, by the young adult.

Fermented Dessert with Whey, Ingredients from the Peel of Jabuticaba (Myrciaria cauliflora) and an Indigenous Culture of Lactobacillus plantarum: Composition, Microbial Viability, Antioxidant Capacity and Sensory Features.

The use of agro-industrial wastes in combination with indigenous lactic acid bacteria is an interesting option to confer functional potential to food products. The microbial viability, chemical composition, antioxidant capacity, texture and sensory acceptability of a fermented dairy dessert containing the indigenous culture Lactobacillus plantarum CNPC003, whey and ingredients obtained from the jabuticaba (Myrciaria cauliflora) peel were compared with formulations without lactobacilli (control) or containing a commercial probiotic culture (Lactobacillus rhamnosus LR32). L. plantarum presented viability higher than 7 log CFU g-1 in the dessert, as did the commercial probiotic, for 21 days at 4 ± 1 °C. Total phenolic contents (45⁻60 mg gallic acid equivalents, GAE, 100 g-1) were comparable to those of other studies evaluating dairy products containing plant sources. The formulations were low in fat, presenting as acceptable for overall consumption, with attractive color and appreciable texture. Considering the total antioxidant capacity, 200⁻250 g of dessert would be necessary to capture 1 g of 1,1-diphenyl-2-picrylhydrazyl (DPPH) radicals. The dessert with Lactobacillus plantarum CNPC003 is seen as a viable alternative for the use of whey and jabuticaba peel, as well as a potential functional food due to the concentration of lactobacilli reached, besides the presence of antioxidant phenolic compounds.

Correction to: Validation of the Community Integration Scale for Adults with Psychiatric Disorders (CIS-APP-34).

The original version of the article unfortunately contained a typo in the author name.

Absence of toxicity in Swiss mice following treatment with 7-acetoxy-4-aryl-3,4-dihydrocoumarin: Acute and repeated-dose toxicity study.

Neoflavonoids, which are classified as 4-arylcoumarin (neoflavone), 3,4-dihydro-4-arylcoumarin and neoflavene, have been the subject of a number of studies with respect to their therapeutic potential and, despite promising in vitro, ex vivo and in vivo pharmacological activities, there is a lack of studies demonstrating their toxicological properties. Therefore, this study aims to evaluate the acute (14 days) and repeated-dose (28 days) toxicity of synthetic neoflavonoid 7-acetoxy-4-aryl-3,4-dihydrocoumarin in Swiss mice through parameters related to changes in body weight, food and water intake, hematological and biochemical parameters. Toxicity studies using acute doses (300 and 2000 mg/kg) and repeated doses (250, 500 and 1000 mg/kg) orally were carried out as per Organization for Economic Co-operation and Development (OECD) guidelines 423 and 407, respectively. Based on the results of this study, treatment with 7-acetoxy-4-aryl-3,4-dihydrocoumarin was found to not cause clinical adverse symptoms and mortality in any animal used in the acute and repeated-dose toxicity study. In addition, no significant changes were observed in body weight and internal organs, food and water intake, hematological and biochemical parameters, compared to control group. Therefore, these results provide an initial understanding regarding the toxicity profile of 7-acetoxy-4-aryl-3,4-dihydrocoumarin, which can be considered a neoflavonoid with toxicity seen at doses higher than 2000 mg/kg in Swiss mice.

Validation of the Community Integration Scale for Adults with Psychiatric Disorders (CIS-APP-34).

The current focus on community integration of individuals with psychiatric problems is attracting an increasing interest in the psychological literature, as it is regarded as a favorable factor in the recovery and for the well-being of these individuals. The Community Integration Scale of Adults with Psychiatric Disorders (CIS-APP-34) is a self-report scale developed to assess community integration in several dimensions. The main goal of the current study is to explore the psychometric properties of CIS-APP-34 in a sample of 411 participants with and without a psychiatric illness, with ages between 19 and 91 years old, living in the Azores Islands, Portugal. A confirmatory factor analysis was carried out to confirm the latent structure of the scale, and a five-factor model has presented good fit indices. Further analysis showed that the CIS-APP-34 is a measure with good reliability, validity and discriminant ability.

Biting myself so I don't bite the dust: prevalence and predictors of deliberate self-harm and suicide ideation in Azorean youths

Objective: To characterize non-suicidal self-injury (NSSI) behaviors, methods, and functions as well as suicide ideation in the adolescent population of a Portuguese community in São Miguel Island, Azores. Increasing rates of NSSI behaviors among adolescents have been observed globally, while suicidal behavior has been pointed as a major cause of death during adolescence. Methods: A sample of 1,763 adolescents, aged 14 to 22, was randomly drawn from public and private schools and administered a set of self-report questionnaires. Descriptive and regression analyses were used to look for specific relationships and predictors of NSSI and suicide ideation in this isolated community. Results: Approximately 30% of youths reported at least one NSSI behavior, a rate that is twice as high as most studies carried out in mainland Portugal and in other European countries. Biting oneself was the most frequent form of NSSI, and NSSI behaviors served predominantly automatic reinforcement purposes (i.e., regulation of disruptive emotional states). NSSI and suicide ideation encompassed different distal and proximal risk factors. Conclusions: Exploring and characterizing these phenomena is necessary to provide a better understanding, enhance current conceptualizations, and guide the development of more effective prevention and intervention strategies in youths.

Biting myself so I don't bite the dust: prevalence and predictors of deliberate self-harm and suicide ideation in Azorean youths.

OBJECTIVE:: To characterize non-suicidal self-injury (NSSI) behaviors, methods, and functions as well as suicide ideation in the adolescent population of a Portuguese community in São Miguel Island, Azores. Increasing rates of NSSI behaviors among adolescents have been observed globally, while suicidal behavior has been pointed as a major cause of death during adolescence. METHODS:: A sample of 1,763 adolescents, aged 14 to 22, was randomly drawn from public and private schools and administered a set of self-report questionnaires. Descriptive and regression analyses were used to look for specific relationships and predictors of NSSI and suicide ideation in this isolated community. RESULTS:: Approximately 30% of youths reported at least one NSSI behavior, a rate that is twice as high as most studies carried out in mainland Portugal and in other European countries. Biting oneself was the most frequent form of NSSI, and NSSI behaviors served predominantly automatic reinforcement purposes (i.e., regulation of disruptive emotional states). NSSI and suicide ideation encompassed different distal and proximal risk factors. CONCLUSIONS:: Exploring and characterizing these phenomena is necessary to provide a better understanding, enhance current conceptualizations, and guide the development of more effective prevention and intervention strategies in youths.