Ophthalmic Manifestations of Heimler Syndrome in Two Siblings With PEX1 Variants.

PURPOSE: To report two new cases with confirmed diagnosis of Heimler syndrome and describe their systemic and ophthalmic phenotype and visual rehabilitation. METHODS: Retrospective review of medical records. RESULTS: Both siblings were diagnosed as having sensori-neural hearing loss and retinal dystrophy with exuberant intraretinal cystoid spaces and cone-rod dysfunction. The older sibling also had amelogenesis imperfecta and neither had nail abnormalities. Genetic analysis identified homozygosity for the pathogenic variant c.2528G>A p.(Gly843Asp) in the PEX1 gene in both siblings. The parents were heterozygous carriers of the variant. CONCLUSIONS: The authors report a familial case of Heimler syndrome due to biallelic PEX1 pathogenic variants that manifested as macular dystrophy characterized by cone-rod dysfunction and complicated by intraretinal cystoid spaces. Review of the literature shows that ocular phenotype is variable in patients with Heimler syndrome. [J Pediatr Ophthalmol Strabismus. 2024;61(1):59-66.].

Early Diagnosis of 46,XX Testicular Difference of Sexual Development: Unusual Presentation with Increased Nuchal Translucency.

INTRODUCTION: 46,XX testicular disorder of sexual development (DSD) may present prenatally as a mismatch between phenotype and karyotype. Enlarged nuchal translucency is an abnormal sign of many disorders. We present a first trimester fetus with increased nuchal translucency that was later determined to be a 46,XX testicular DSD. CASE PRESENTATION: A first-trimester pregnancy ultrasound revealed enlarged nuchal translucency. Chorionic villous sampling documented a 46,XX karyotype. Subsequent ultrasounds identified male external genitalia. FISH analysis documented a SRY gene translocation. At birth, the infant had normal male internal and external genitalia. CONCLUSIONS: 46,XX testicular DSD may present in the first trimester with an enlarged nuchal translucency.

Combined Oxidative Phosphorylation Deficiency Type-13 with Perinatal Presentation: A Case Report.

INTRODUCTION: Polynucleotide phosphorylase is involved in RNA processing in mitochondria. Biallelic variants in PNPT1 cause mitochondrial RNA import protein deficiency and heterogeneous clinical manifestations. CASE REPORT: The patiest was the first child of remote consanguineous parents, born at 35 weeks by caesarean section due to fetal growth restriction. Apgar index was 9/10/10. Birth weight, length and head circumference were at 3rd, <3rd and 10th percentiles, respectively. In the first hours of life, respiratory distress, hypoglycaemia and seizures ensued. She started invasive mechanic ventilation, phenobarbital and was transferred to ICU. Physical examination showed minor facial dysmorphisms, brief eye-opening, hypotonia and hyporeflexia. Electroencephalogram showed immature pattern and multifocal paroxysmal activity. MRI at D8 of life showed severe reduced brain volume. Normal aminoacid screen was also observed. Expanded newborn screening was negative. Mitochondrial organic aciduria was seen. WES showed a homozygotic likely pathogenic variant in the PNPT1 gene. MRI at 6-months showed brain atrophy, thin corpus callosum, reduced brainstem volume. Bilateral and symmetrical lesions in globi pallidi, compatible with Leigh síndrome were observed. Currently, at 14 months, no neurodevelopment progress, dystonia, visual deficit, sensorineural deafness, hypertrophic cardiomyopathy and microcephaly are observed. CONCLUSION: The early and severe Leigh-like presentation of our patient expands the phenotype spectrum of this disease. As far as we know, this is the first reported case of PNPT1 mutation with onset in the perinatal period. Moreover, hypertrophic cardiomyopathy has not yet been described in association with mutation of the PNPT1 gene. WES was the key for early diagnosis in this patient. It should be done in all children with severe clinical presentation of unknown origin.

Advantages of current fetal neuroimaging and genomic technologies in prenatal diagnosis: A clinical case.

The diagnosis of prenatal microcephaly, as well as the possibility of underlining a genetic cause, is becoming more frequent thanks to advances in prenatal imaging and parallel massive sequencing. One case of primary microcephaly in three sibs demonstrates how complementary diagnostic exams can help to diagnose and establish the etiology.

Intervención psicológica corta para promoción del enfrentamiento de los estresores en la enseñanza universitaria / Intervenção psicológica breve para promoção do enfrentamento dos estressores no ensino superior / Brief psychologycal intervention for the promotion of ways to cope with stressors in higher education

O ingresso no Ensino Superior inclui estressores variados para o estudante e a literatura aponta a necessidade de intervenções para facilitar a adaptação à universidade. A oficina de vivências acadêmicas, uma intervenção psicológica breve (8 sessões) de base analítico-comportamental, buscou desenvolver repertórios para o enfrentamento dos estressores presentes no Ensino Superior. Participaram 9 acadêmicas de enfermagem, que após consentimento, responderam antes e após a participação na oficina: 1) o Self-Reporting Questionnaire, versão brasileira, um instrumento de triagem de sintomas relacionados a transtornos mentais comuns (TMC); e 2) a Escala de Bem-estar Psicológico (EBEP). Inicialmente, 88,9% das participantes apresentavam sintomas de TMC, e a média da EBEP foi 24,97 (DP=1,22). Após a intervenção, somente 22,2% das estudantes continuaram apresentando sintomas de TMC, e a média da EBEP aumentou para 29,34 (DP=1,17). As implicações dessa intervenção são discutidas tendo em vista os desafios enfrentados pela Psicologia Escolar e Educacional no Ensino Superior.

La entrada en la enseñanza universitaria incluye estresores variados para el estudiante y la literatura apunta la necesidad de intervenciones para facilitar la adaptación a la universidad. El taller de vivencias académicas, una intervención psicológica corta (8 sesiones) de base analítico-comportamental, buscó desarrollar repertorios para el enfrentamiento de los estresores presentes en la enseñanza universitaria. Participaron 9 académicas de enfermería que, tras consentimiento, respondieron antes y después la participación en el taller: 1) el Self-Reporting Questionnaire, versión brasileña, un instrumento de selección de síntomas relacionados a trastornos mentales comunes (TMC); y 2) la Escala de Buen-estar Psicológico (EBEP). Inicialmente, el 88,9% de las participantes presentaban síntomas de TMC, y el promedio de la EBEP fue 24,97 (DP=1,22). Tras la intervención, solamente el 22,2% de las estudiantes continuaron presentando síntomas de TMC, y el promedio de la EBEP aumentó para 29,34 (DP=1,17). Las implicaciones de esta intervención son discutidas teniendo en vista los desafíos enfrentados por la Psicología Escolar y Educacional en la enseñanza universitaria.

Enrolling in Higher Education includes various stressors for the student and the literature points to the need for interventions to facilitate adaptation to university. The academic experiences workshop, a brief psychological intervention (8 sessions) based on behavioral analysis, sought to develop repertoires for coping with the stressors present in higher education. Nine nursing students participated after signing consent terms. They provide answers before and after participating in the workshop: 1) the Self-Reporting Questionnaire, Brazilian version, an instrument for screening symptoms related to common mental disorders (CMD); and 2) the Psychological Well-Being Scale (PBS). Initially, 88.9% of participants had symptoms of CMD, and the mean EBEP was 24.97 (SD=1.22). After the intervention, only 22.2% of the students continued to present symptoms of CMD, and the mean EBEP increased to 29.34 (SD=1.17). The implications of this intervention are discussed in view of the challenges faced by School and Educational Psychology in Higher Education.

Stressors and maternal Coping in Congenital Zika virus Syndrome / Estressores e Coping materno no contexto da Síndrome Congênita do vírus Zika

Objective: Congenital Zika virus Syndrome is characterized by a series of neurological changes bearing consequences for child development. In view of the large number of children born with microcephaly and other neurological disorders, this qualitative study sought to understand and review the coping strategies used by 10 mothers of children affected by the syndrome. Methods: A semi-structured interview was applied, which identified four main maternal stressors: diagnosis; childcare routine; child treatment; and development and access to health services. Results: The most used coping strategies with regard to these stressors were: information-seeking, problem-solving, and delegation. Conclusion: The implications of such results for the care of this population are discussed within the perspective of expanding the adaptive coping to these stressors and ensuring the necessary support for those families in the long and difficult process of taking care of a child with this syndrome.

Objetivo: A síndrome congênita do vírus Zika é caracterizada por uma série de alterações neurológicas com consequências para o desenvolvimento da criança. Diante do elevado número de crianças afetadas pela síndrome, nascidas com microcefalia e outros distúrbios neurológico, este estudo qualitativo buscou compreender e analisar as estratégias de coping utilizadas por 10 mães de crianças afetadas nessa situação. Método: Foi utilizada uma entrevista semiestruturada, que identificou quatro principais estressores maternos: o diagnóstico; a rotina e os cuidados com a criança; o tratamento e desenvolvimento da criança e a dificuldade de acesso aos serviços de saúde. Resultados: As estratégias de enfrentamento mais utilizadas para lidar com esses estressores foram: busca de informações, resolução de problemas e delegação. Conclusão: Discutem-se as implicações desses resultados para o cuidado das mães na perspectiva de ampliar o enfrentamento adaptativo aos estressores e garantir o suporte necessário às famílias no longo e difícil processo de cuidar de uma criança com a Síndrome Congênita do Vírus Zika.

Ultrasound and molecular prenatal diagnosis of Beckwith-Wiedemann syndrome: Two case reports.

Beckwith-Wiedemann syndrome (BWS) is a rare genetic disease, characterized by macrosomia, congenital malformations and tumor predisposition, associated with genetic and epigenetic alterations in the 11p15 region. Most cases are diagnosed after birth, with prenatal diagnosis being difficult and depending on the identification of specific ultrasound anomalies, namely macrosomia, macroglossia, omphalocele and renal dysplasia. Case 1: Ultrasound diagnosis at 13 weeks of isolated omphalocele with normal array. At 20 weeks, there were shortened fetal long bones, foot deformity, macroglossia, corpus callosum hypoplasia and bilateral nephromegaly. Due to the polymalformative syndrome, a termination of pregnancy (TOP) was performed. The anatomopathological study of the placenta identified mesenchymal dysplasia. The search for the methylation pattern of the 11p15 region by MS-MLPA was normal and the molecular study of the CDKN1C gene identified a likely pathogenic variant, inherited from the mother. Case 2: Morphological ultrasound at 21 weeks revealed macrosomia, macroglossia, omphalocele, bilateral renal dysplasia, and hydramnios. The cytogenetic study, after amniocentesis, was normal (46,XX karyotype). TOP was performed. The anatomopathological study of the fetus confirmed the described malformations and the one concerning the placenta identified placentomegaly. The search for the methylation pattern of the 11p15 region by MS-MLPA revealed abnormal methylation. These results confirmed the diagnosis of BWS in both cases. Prenatal ultrasound suspicion of this pathology is extremely important to guide the conduct in pregnancy and/or the prevention of perinatal complications. Shortened fetal long bones and foot deformity complement the broad spectrum of this syndrome. Positive molecular tests allow confirming the diagnosis, assessing the risk of recurrence and guiding the surveillance of future pregnancy.

A serious and unusual presentation of congenital isolated ACTH deficiency due to TBX19 mutation, beyond the neonatal period.

Summary: Congenital isolated adrenocorticotrophic hormone (ACTH) deficiency due to T-box transcription factor-19 (TBX19 mutation) (MIM 201400; ORPHA 199296) usually presents in the neonatal period with severe hypoglycemia, seizures, and sometimes prolonged cholestatic jaundice. We report a case with an unusual presentation that delayed the diagnosis. A 9-month-old female patient with no relevant personal history was admitted to the emergency department due to a hypoglycemic seizure in the context of acute gastroenteritis. There was rapid recovery after glucose administration. At age 4, she presented with tonic-clonic seizures, fever, and gastrointestinal symptoms and came to need support in an intensive care unit. Low serum cortisol was documented and hydrocortisone was initiated. After normalization of inflammatory parameters, the patient was discharged with hydrocortisone. The genetic investigation was requested and compound heterozygous mutations in TBX19 were detected. This is a rare case of presentation of TBX19 mutation outside the neonatal period and in the setting of acute disease, which presented a diagnostic challenge. Learning points: Congenital isolated adrenocorticotrophic hormone deficiency due to TBX19 mutation usually presents with neonatal hypoglycemia and prolonged cholestatic jaundice. An uneventful neonatal period, however, does not exclude the diagnosis as the disease may be asymptomatic at this stage. In the context of idiopathic hypoglycemia, even in the context of acute disease, hypocortisolism must always be excluded. Genetic evaluation should be performed in cases of congenital central hypocortisolism to allow proper counselling.

Association between the orientation received during hospitalization and the occurrence of wound healing.

OBJECTIVES: to assess whether there is an association between the orientation received during hospitalization and the occurrence of wound healing from the patient's perspective after hospital discharge. METHODS: concurrent cohort, with 180-day follow-up, held in Dermatology Ward. A total of 62 patients with wounds requiring care after discharge were evaluated between July 2015 and November 2016. Information about the orientation was obtained by phone call between 7 and 10, 60, 120 and 180 days after discharge. RESULTS: the older the patient, the lower the chance of healing in up to ten days; and the longer the hospitalization, the lower the chance of healing. They received orientation in the high 90.3%, while 87% understood the orientations. CONCLUSIONS: there was no association between the orientation received during hospitalization and the occurrence of wound healing from the patient's perspective after hospital discharge.

DEPDC5 variant in focal cortical dysplasia: a case report and review of the literature.

Germline and 2-hit brain somatic variants in DEPDC5 gene, a negative regulator of the mammalian target of rapamycin (mTOR) pathway, are increasingly recognized in patients with focal cortical dysplasia (FCD). Next-generation targeted sequencing identified a heterozygous germline variant in DEPDC5 gene (c.3241A>C, p.Thr1081Pro), classified as of unknown significance, in a patient with clinical features compatible with DEPDC5 phenotype (FCD, focal epilepsy, attention-deficit/hyperactivity disorder and borderline intellectual functioning). This missense variant has previously been reported in two other epileptic patients. Although interpretation of missense variants remains a challenge, DEPDC5 variants in patients with FCD and epilepsy cannot be neglected. Null variants were the most frequently reported in FCD patients, but missense variants have been described as well. The recognition of DEPDC5 phenotype and the appropriate interpretation of the detected variants are essential, since it may have important treatment implications in the near future, namely the use of mTOR inhibitors.

Simpson-Golabi-Behmel syndrome: One family, same mutation, different outcome.

Simpson-Golabi-Behmel syndrome (SGBS) is a rare X-linked condition characterized by pre and postnatal overgrowth with visceral and skeletal abnormalities. The syndrome is caused mainly by mutations in the X-linked gene GPC3. Clinical presentation of SGBS in affected males is well defined, but there is a lack of knowledge about affected females, with very few reported cases. In total, eight female carriers with clinical expression of SGBS have been reported to date. In the present report, we describe the ninth patient and her family history. The interesting features of our female patient are the Wilms' tumor and the transfontanelar ultrasound findings. The patient's older sister, carrier of the same mutation, has minor facial dysmorphisms but no congenital anomalies and so far, no further clinical findings, as well as her mother and grandmother. There is a lesson to be learned from these rare cases, namely that SGBS may have a significant clinical expression in females, and therefore, screening should be considered in all patients with SGBS regardless of the sex or phenotypic severity.

Mental health in the Covid-19 pandemic: possible contributions from Functional Analytic Psychotherapy

Several studies point out problems in interpersonal relationships as precipitating or aggravating mental health issues. Especially in the Covid-19 pandemic scenario, which requires isolation and social distance, it is necessary to pay attention to the issues that emerge in interpersonal relationships. Functional Analytic Psychotherapy (FAP), a form of behavioral therapy that emphasizes the role of the therapist-client interpersonal relationships in improving client problems, can contribute to the proposition of interventions to address mental health issues in this pandemic. This study aimed to describe a perspective about the application of FAP on the treatment of mental disorders, mainly with anxious or depressive symptoms, and correlate such findings with interventions aimed at the Covid-19 pandemic. A narrative review of the literature was carried out based on bibliographic searches on the "Portal de Periódicos da CAPES". The review materials were organized into (a) treatment of mental health problems using FAP, sorted into themes of anxiety, depression, and a combination of them; (b) FAP, mental health, and the Covid-19 pandemic. It is concluded that FAP can be used as an essential theoretical and methodological framework for planning interventions during and after the Covid-19 pandemic, minimizing its possible harmful effects.(AU)

Vários estudos demonstram como dificuldades no relacionamento interpessoal podem precipitar ou agravar problemas de saúde mental. A emergência dessas questões merece mais atenção, principalmente no cenário de isolamento e distanciamento social imposto pela pandemia do Covid-19. A Psicoterapia Analítica Funcional (FAP), uma forma de terapia comportamental que enfatiza o papel do relacionamento interpessoal na melhoria dos clientes pode auxiliar na proposição de intervenções destinadas a abordar questões de saúde mental durante o cenário atual. Este estudo objetivou descrever uma perspectiva sobre a utilização da FAP no tratamento de transtornos mentais que têm como foco a sintomatologia ansiosa ou depressiva, relacionando esses achados a intervenções voltadas para a pandemia da Covid-19. Foi realizada uma revisão narrativa da literatura a partir de buscas bibliográficas no Portal de Periódicos da CAPES. Os materiais da revisão foram organizados em: (a) tratamento de problemas de saúde mental usando a FAP, agrupados a partir dos temas ansiedade, depressão e uma combinação desses temas; (b) FAP, saúde mental e a pandemia de Covid-19. Conclui-se que a FAP pode ser utilizada como um referencial teórico-metodológico importante para o planejamento de intervenções durante e após a pandemia de Covid-19, minimizando seus possíveis efeitos negativos.(AU)

Varios estudios demuestran cómo los problemas de relación interpersonal pueden precipitar o agravar los problemas de salud mental. La emergencia de estos problemas merece mayor atención, especialmente en el escenario de aislamiento y distanciamiento social impuesto por la pandemia de Covid-19. La Psicoterapia Analítica Funcional (FAP), una forma de terapia conductual que enfatiza el papel de las relaciones interpersonales en la mejora de los clientes, puede ayudar a proponer intervenciones destinadas a abordar los problemas de salud mental en el escenario actual. Este estudio tuvo como objetivo describir una perspectiva sobre el uso de la FAP en el tratamiento de trastornos mentales que se centran en síntomas ansiosos o depresivos, relacionando estos hallazgos con intervenciones dirigidas a la pandemia de Covid-19. Se llevó a cabo una revisión narrativa de la literatura a partir de búsquedas bibliográficas en el "Portal de Periódicos da CAPES". Los materiales de revisión se organizaron en: (a) tratamiento de problemas de salud mental utilizando FAP, agrupados en función de los temas ansiedad, depresión y una combinación de estos temas; (b) FAP, salud mental y la pandemia de Covid-19. Resulta que se puede utilizar FAP como un marco metodológico teórico importante para planificar intervenciones durante y después la pandemia de Covid-19, minimizando sus posibles efectos nocivos.(AU)

Association between the orientation received during hospitalization and the occurrence of wound healing / Relación entre la orientación recibida durante la internación y la ocurrencia de cicatrización de heridas / Associação entre a orientação recebida durante a internação e a ocorrência de cicatrização de feridas

ABSTRACT Objectives: to assess whether there is an association between the orientation received during hospitalization and the occurrence of wound healing from the patient's perspective after hospital discharge. Methods: concurrent cohort, with 180-day follow-up, held in Dermatology Ward. A total of 62 patients with wounds requiring care after discharge were evaluated between July 2015 and November 2016. Information about the orientation was obtained by phone call between 7 and 10, 60, 120 and 180 days after discharge. Results: the older the patient, the lower the chance of healing in up to ten days; and the longer the hospitalization, the lower the chance of healing. They received orientation in the high 90.3%, while 87% understood the orientations. Conclusions: there was no association between the orientation received during hospitalization and the occurrence of wound healing from the patient's perspective after hospital discharge.

RESUMEN Objetivos: evaluar si hay relación entre la orientación recibida durante la internación y la ocurrencia de cicatrización de heridas en la perspectiva del paciente después del alta hospitalaria. Métodos: corte concurrente, con follow-up de 180 días, realizada en Enfermería de Dermatología. Se evaluaron 62 pacientes con heridas que necesitaran de cuidado después del alta, entre julio de 2015 y noviembre de 2016. Informaciones sobre la orientación han sido obtenidas por llamada telefónica entre 7 y 10, 60, 120 y 180 días después del alta. Resultados: cuanto mayor la edad, menor la chance de cicatrización en hasta 10 días; y cuanto mayor el tiempo de internación, menor la chance de cicatrización. Recibieran orientación en la alta 90,3%, mientras 87% comprendieran las orientaciones. Conclusiones: no hubo relación entre la orientación recibida durante la internación y la ocurrencia de cicatrización de heridas en la perspectiva del paciente después del alta hospitalaria.

RESUMO Objetivos: avaliar se há associação entre a orientação recebida durante a internação e a ocorrência de cicatrização de feridas na perspectiva do paciente após a alta hospitalar. Métodos: coorte concorrente, com follow-up de 180 dias, realizada em Enfermaria de Dermatologia. Foram avaliados 62 pacientes com feridas que necessitaram de cuidado após alta, entre julho de 2015 e novembro de 2016. Informações sobre a orientação foram obtidas por ligação telefônica entre 7 e 10, 60, 120 e 180 dias após alta. Resultados: quanto maior a idade, menor a chance de cicatrização em até 10 dias; e quanto maior o tempo de internação, menor a chance de cicatrização. Receberam orientação na alta 90,3%, enquanto 87% entenderam as orientações. Conclusões: não houve associação entre a orientação recebida durante a internação e a ocorrência de cicatrização de feridas na perspectiva do paciente após a alta hospitalar.

Procrastinación académica en estudiantes universitarios: una revisión sistemática de la literatura / Procrastinação acadêmica em estudantes universitários: uma revisão sistemática da literatura / Academic procrastination in university students: a systematic review of the literature

Procrastinação acadêmica é o adiamento de tarefas relacionadas aos estudos: realizar trabalhos, ler textos, estudar para provas, dentre outros. Este artigo teve como objetivo realizar uma revisão sistemática da literatura sobre procrastinação acadêmica em universitários, no período de 2008 a 2017. Foram escolhidas 3 bases de dados: SciELO, BvSalud e BvsPsi, com os descritores "procrastinação", "universitários", "procrastinação acadêmica" e seus correlatos em inglês e espanhol. A partir dos critérios de inclusão e exclusão foram selecionados 11 artigos completos. A maior parte dos trabalhos apontou a natureza nociva do comportamento procrastinatório, sua relação com a autorregulação da aprendizagem, bem como a diferença das estratégias de estudo empregadas por alunos procrastinadores e não procrastinadores. Concluiu-se que a pesquisa sobre a temática ainda é incipiente no contexto brasileiro necessitando de maior exploração por parte dos pesquisadores, com possíveis impactos para a compreensão do fenômeno e desenvolvimento de intervenções com estudantes do ensino superior.

Procrastinación académica es la postergación de tareas relacionadas a los estudios: realizar tareas, leer textos, estudiar para exámenes, entre otros. En este artículo se tuvo como objetivo realizar una revisión sistemática de la literatura sobre procrastinación académica en universitarios, en el período de 2008 a 2017. Se eligieron 3 bases de datos: SciELO, BvSalud y BvsPsi, con los descriptores "procrastinación", "universitarios", "procrastinación académica" y sus correlatos en inglés y portugués. A partir de los criterios de inclusión y exclusión se seleccionaron 11 artículos completos. La mayor parte de los estudios apuntó la naturaleza nociva del comportamiento de procrastinación, su relación con la autorregulación del aprendizaje, así como la diferencia de las estrategias de estudio empleas por alumnos procrastinadores y no procrastinadores. Se concluyó que la investigación sobre la temática aún es incipiente en el contexto brasileño necesitando de más exploración por parte de los investigadores, con posibles impactos para la comprensión del fenómeno y desarrollo de intervenciones con estudiantes de la enseñanza universitaria.

Academic procrastination is the postponement of tasks related to studies: doing work, reading texts, studying for exams, among others. This article aimed to perform a systematic review of the literature about academic procrastination in university students, from 2008 to 2017. Three databases were chosen: SciELO, BvSalud and BvsPsi, with the combination of the descriptors "procrastination", "university students", "college students", "undergraduate students", "academic procrastination" was used, as well as derivations in Portuguese and Spanish. From the inclusion and exclusion criteria, 11 complete articles were selected. Most of the works pointed out the harmful nature of procrastinatory behavior, its relationship with the self-regulation of learning, as well as the difference in the study strategies used by procrastinating and non-procrastinating students. It was concluded that research about the theme is still incipient in the Brazilian context, requiring further exploration by researchers, with possible impacts for understanding the phenomenon and developing interventions with higher education students.

Helping Couples Connect during the COVID-19 Pandemic: A Pilot Randomised Controlled Trial of an Awareness, Courage, and Love Intervention.

BACKGROUND: A second pandemic of mental health problems due to COVID-19 is predicted, suggesting a demand for interventions to mitigate its impacts. This study evaluated the effectiveness of an online psychological intervention based on the Awareness, Courage, and Love (ACL) model from Functional Analytic Psychotherapy to promote closeness between couples during the pandemic. METHOD: Thirty-one couples were randomised into either the intervention or control group for a 2-hour online group session. The intervention was designed to increase closeness between couples, whereas control group members watched a movie. In both groups, participants responded to two instruments that assessed the couple's relationship. Generalised linear mixed modeling was used to compare the change scores over time between the groups, with random effects used to control for the correlation within a couple and the correlation within the individual. RESULTS: The intervention group's closeness increased by 23 per cent while the control group's closeness increased only 2 per cent. A week later, a significant difference between the two groups emerged on closeness. CONCLUSION: Online ACL protocols requiring minimal training offer a promising intervention to quickly buffer against stress for large numbers of individuals during pandemic times.

Visita domiciliar como suporte da enfermagem na diálise peritoneal: revisão integrativa / Visita domiciliaria como asistencia de enfermería en la diálisis peritoneal: revisión integradora / Home visit as a support for nursing in peritoneal dialysis: an integrative review

Resumo Objetivo Identificar na literatura como a visita domiciliar é utilizada pelo enfermeiro como ferramenta do cuidado em dialise peritoneal domiciliar. Métodos Revisão integrativa da literatura de artigos em periódicos, a partir de uma questão norteadora, no período de janeiro de 2014 a janeiro de 2019. A busca bibliográfica foi realizada nas bases Scielo; Web of Science, Pubmed, Scopus, Embase e Cinahl. Resultados Identificaram-se 10 artigos de acordo com as etapas da revisão e as respostas à pergunta norteadora. A visita domiciliar realizada pelo enfermeiro foi descrita como ferramenta de adesão ao tratamento. A prevenção de complicações, como a peritonite, foi citada pelos autores, que em sua maioria, eram médicos e enfermeiros. Conclusão O enfermeiro assiste integralmente ao paciente e família e, assegura o tratamento proposto com fidedignidade. As intervenções de enfermagem no domicílio previnem eventos adversos e frequente avaliação de indicadores do tratamento. Estimular estudos primários nessa área é imprescindível, visto que poucos estudos sobre a temática foram identificados na presente revisão.

Resumen Objetivo Identificar en la literatura cómo se utiliza la visita domiciliaria del enfermero como herramienta de cuidado en diálisis peritoneal domiciliaria. Métodos Revisión integradora de la literatura de artículos en revistas especializadas, a partir de una pregunta orientadora, en el período de enero de 2014 a enero de 2019. La búsqueda bibliográfica fue realizada en las bases Scielo, Web of Science, Pubmed, Scopus, Embase y Cinahl. Resultados Se identificaron diez artículos de acuerdo con las etapas de la revisión y las respuestas a la pregunta orientadora. La visita domiciliaria realizada por el enfermero se describió como herramienta de adherencia al tratamiento. La prevención de complicaciones, como la peritonitis, fue citada por los autores que, en su mayoría eran médicos y enfermeros. Conclusión El enfermero asiste al paciente y a la familia de forma integral y garantiza que el tratamiento propuesto sea fidedigno. Las intervenciones de enfermería en el domicilio previenen eventos adversos y una evaluación frecuente de indicadores del tratamiento. Es imprescindible estimular estudios primarios en esta área, ya que se identificaron pocos estudios sobre esta temática en la presente revisión.

Abstract Objective To identify in the literature how home visit is used by nurses as a tool of care in home peritoneal dialysis. Methods An integrative review of the literature of articles in journals, from a guiding question, from January 2014 to January 2019. The bibliographic search was carried out at Scielo, Web of Science, Pubmed, Scopus, Embase, and CINAHL databases. Results Ten articles were identified according to the review steps and the answers to the guiding question. The home visit performed by nurses was described as a treatment adherence tool. Complication prevention, such as peritonitis, was cited by the authors, who were mostly physicians and nurses. Conclusion Nurses assist patients and family members in full and ensure the proposed treatment with reliability. Nursing interventions at home prevent adverse events and frequent assessment of treatment indicators. Boosting primary studies in this area is essential, since few studies on the subject have been identified in the present review.

Aspects that influence the self-care of patients living with human immunodeficiency virus.

OBJECTIVE: to analyze aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus treated in a specialized outpatient service. METHOD: analytical cross-sectional study with 135 patients aged 18 and over, of both sexes, who are followed up on the service. The independent variables and outcomes were collected from the nursing consultation instrument, whose theoretical reference is the Orem's Theory. The data were analyzed by parametric approach. Relationships or differences were considered significant if p <0.05. The analysis was done with SPSS v21.0 software. RESULTS: most participants were male (56.3%), with a mean age of 42.1 years. Patients who needed to conceal the diagnosis had less self-care (ß = -0.72 (-1.38, -0.06), p <0.031). The chance of performing self-care decreased with increasing age (OR = 0.93 (0.89, 0.97), p <0.003). On the other hand, patients with a permanent partner had a higher chance of performing self-care (OR = 3.46 (1.27, 9.46), p <0.015). CONCLUSION: aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus were evidenced. However, further studies are necessary to emphasize the analytical character of the self-care of these patients.

Aspects that influence the self-care of patients living with human immunodeficiency virus / Aspectos que influenciam o autocuidado de pacientes vivendo com vírus da imunodeficiência humana / Aspectos que influyen en el autocuidado de pacientes viviendo con virus de la inmunodeficiencia humana

ABSTRACT Objective: to analyze aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus treated in a specialized outpatient service. Method: analytical cross-sectional study with 135 patients aged 18 and over, of both sexes, who are followed up on the service. The independent variables and outcomes were collected from the nursing consultation instrument, whose theoretical reference is the Orem's Theory. The data were analyzed by parametric approach. Relationships or differences were considered significant if p <0.05. The analysis was done with SPSS v21.0 software. Results: most participants were male (56.3%), with a mean age of 42.1 years. Patients who needed to conceal the diagnosis had less self-care (β = -0.72 (-1.38, -0.06), p <0.031). The chance of performing self-care decreased with increasing age (OR = 0.93 (0.89, 0.97), p <0.003). On the other hand, patients with a permanent partner had a higher chance of performing self-care (OR = 3.46 (1.27, 9.46), p <0.015). Conclusion: aspects related to the increase or decrease of self-care in patients living with human immunodeficiency virus were evidenced. However, further studies are necessary to emphasize the analytical character of the self-care of these patients.

RESUMO Objetivo: analisar aspectos relacionados ao aumento ou diminuição do autocuidado nos pacientes vivendo com vírus da imunodeficiência humana atendidos em serviço de ambulatório especializado. Método: estudo transversal de caráter analítico com 135 pacientes com idade maior ou igual a 18 anos, de ambos os sexos, que fazem acompanhamento no serviço. As variáveis independentes e os desfechos foram coletados do instrumento da consulta de enfermagem, que tem como referencial teórico a Teoria de Orem. Os dados foram analisados por abordagem paramétrica. Relações ou diferenças foram consideradas significativas se p < 0,05. A análise foi feita com o software SPSS v21.0. Resultados: maioria do sexo masculino (56,3%), com média de idade de 42,1 anos. Os pacientes que necessitaram ocultar o diagnóstico desempenharam menos autocuidado (β= -0,72 (-1,38; -0,06); p<0,031). A chance de realizar o autocuidado diminuiu em relação ao aumento da idade (OR=0,93 (0,89;0,97);p<0,003). Por outro lado, encontrou-se que o paciente que tem parceria fixa possui maior chance de desempenhar o autocuidado (OR=3,46 (1,27;9,46); p<0,015). Conclusão: foram evidenciados aspectos relacionados ao aumento ou à diminuição do autocuidado nos pacientes que vivem com vírus da imunodeficiência humana. No entanto, fazem-se necessários outros estudos que privilegiem o caráter analítico do desempenho do autocuidado desses pacientes.

RESUMEN Objetivo: analizar los aspectos relacionados al aumento o disminución del autocuidado en los pacientes viviendo con el virus de la inmunodeficiencia humana que fueron atendidos en servicio de ambulatorio especializado. Método: estudio transversal de carácter analítico con 135 pacientes con edad mayor o igual a 18 años, de ambos sexos, que hacen seguimiento en el servicio. Las variables independientes y los resultados fueron recolectados del instrumento de la consulta de enfermería, que tiene como referencial teórico la Teoría de Orem. Los datos se analizaron mediante un enfoque paramétrico. Las relaciones o diferencias se consideraron como significativas si p <0,05. El análisis se realizó con el software SPSS v21.0. Resultados: la mayoría del sexo masculino (56,3%), con una media de edad de 42,1 años. Los pacientes que necesitaban ocultar el diagnóstico desempeñaron menos autocuidado (β= -0,72 (-1,38; -0,06), p<0,031). La probabilidad de realizar el autocuidado disminuyó en relación al aumento de la edad (OR=0,93 (0,89, 0,97), p<0,003). Por otro lado, se encontró que el paciente que tiene asociación fija tiene mayor probabilidad de desempeñar el autocuidado (OR=3,46 (1,27, 9,46), p<0,015). Conclusión: se evidenciaron aspectos relacionados al aumento o a la disminución del autocuidado en los pacientes que viven con virus de la inmunodeficiencia humana. Sin embargo, se hacen necesarios otros estudios que privilegien el carácter analítico del desempeño del autocuidado de esos pacientes.

Tradução e adaptação transcultural do questionário de pais como contexto social / Translation and cross-cultural adaptation of the parents as social context questionnaire / Traducción y adaptación transcultural del cuestionario de padres como contexto social

Este estudo descreve o processo de adaptação transcultural do Parents as Social Context Questionnaire (PASC), em duas versões (pais e criança), um instrumento que avalia a influência parental no enfrentamento infantil em seis dimensões: afeto, rejeição, estrutura, caos, suporte para autonomia e coerção. A tradução foi realizada por dois especialistas em língua inglesa. Três juízes avaliaram clareza de linguagem, pertinência prática e relevância teórica dos 54 itens (24 na versão criança; 30 na versão pais) do instrumento. O coeficiente de validade de conteúdo apresentou, em ambas as versões, classificação substancial (0,60 ­ 0,80) ou quase perfeita (0,80 ­ 1,00) para todos os itens. O questionário foi aplicado em 60 crianças (M=9,6 anos) hospitalizadas e em seus cuidadores (M=34,9 anos). As dimensões com maiores médias foram estrutura, autonomia e afeto (protocolo pais); afeto, autonomia e estrutura (protocolo crianças). Nova pesquisa é necessária para dar seguimento à validação do instrumento para a população brasileira. (AU)

This article describes the process of cross-cultural adaptation of the two versions (parents and child) of the Parents as Social Context Questionnaire (PSCQ), an instrument that assesses the parental influence on child coping through six dimensions: warmth, rejection, structure, chaos, autonomy support and coercion. Two specialists in English language performed the translation. Three judges evaluated the language clarity, practical relevance and theoretical relevance of the 54 items (24 in the child version, 30 in the parent version) of the instrument. The Content Validity Coefficient presented, in both versions, substantial (0.60 ­ 0.80) or almost perfect (0.80 ­ 1.00) classifications for all items. The questionnaire was applied with 60 hospitalized children (M=9.6 years) and their caregivers (M=34.9 years). The dimensions with higher means were structure, autonomy support and warmth (parent version); and warmth, autonomy support and structure (child version). Further research is necessary to continue the validation of the instrument for the Brazilian population. (AU)

Este estudio describe el proceso de adaptación transcultural del Parents as Social Context Questionnaire (PASC), en dos versiones (padres y niño), un instrumento que evalúa la influencia parental en el enfrentamiento infantil en seis dimensiones: afecto, rechazo, estructura, caos, soporte para autonomía y coerción. La traducción fue realizada por dos expertos en lengua inglesa. Tres jueces evaluaron la claridad del lenguaje, la pertinencia práctica y la relevancia teórica de los 54 ítems (24 en la versión niño; 30 en la versión padres) del instrumento. El Coeficiente de Validez de Contenido presentó, en ambas versiones, clasificación sustancial (0,60 ­ 0,80) o casi perfecta (0,80 ­ 1,00) para todos los ítems. El cuestionario fue aplicado en 60 niños (M=9,6 años) hospitalizados y sus cuidadores (M=34,9 años). Las dimensiones con mayores promedios fueron estructura, autonomía y afecto (protocolo padres); afecto, autonomía y estructura (protocolo niño). Una nueva investigación es necesaria para dar seguimiento a la validez del instrumento para la población brasileña. (AU)

Intervenções psicológicas com universitários em serviços de apoio ao estudante / Psychological interventions with university students in student support services / Intervenciones psicológicas con universitarios en servicios de apoyo al estudiante

O ingresso no ensino superior apresenta desafios, sendo importante oferecer programas que promovam a saúde mental do universitário e o preparem para a realidade profissional e para os desafios da carreira. Neste artigo são descritas propostas de intervenções psicológicas com universitários (objetivos e metodologias) desenvolvidas nos anos de 2015 a 2017, por 86 graduandos em Psicologia, e que beneficiaram 705 universitários: 1. acolhimento e triagem psicológica; 2. oficinas: de preparação para a vida acadêmica, de habilidades sociais, de controle da ansiedade e enfrentamento do estresse, de orientação aos estudos, e de temática específica; 3. psicoterapia individual; e 4. educação para a carreira. Discute-se a contribuição dessas intervenções para a proposição de outros serviços que atendam às demandas da população universitária.

Admission to higher education presents challenges, and it is important to offer programs that promote the mental health of the university and prepare it for professional reality and for career challenges. In this article, psychological interventions with university students (objectives and methodologies) developed in the years 2015 to 2017 by 86 undergraduates in Psychology are described, benefiting 705 graduate students: 1. reception and psychological screening; 2. workshops: preparation for academic life, social skills, anxiety control and coping with stress, orientation to studies, and specific topics; 3. individual psychotherapy; and 4. career education. We discuss the contribution of these interventions to the proposal of other services that meet the demands of the university population.

El ingreso en la enseñanza superior presenta desafíos, siendo importante ofrecer programas que promuevan la salud mental del universitario y lo preparen para la realidad profesional y de la carrera. En este artículo se describen propuestas de intervenciones psicológicas con estudiantes universitarios (objetivos y metodologías) desarrolladas entre 2015 y 2017, por 86 graduandos en Psicología, y que beneficiaron a 705 estudiantes universitarios: 1. acogida y clasificación psicológica; 2. talleres: preparación para la vida académica, habilidades sociales, control de la ansiedad y enfrentamiento del estrés, orientación a los estudios, y de temática específica; 3. psicoterapia individual; y 4.educación para la carrera. Se discute la contribución de esas intervenciones para la proposición de otros servicios que atiendan a las demandas de la población universitaria.