Fungal removal of cyanotoxins in constructed wetlands: The forgotten degraders.

Harmful cyanobacterial blooms have increased globally, releasing hazardous cyanotoxins that threaten the safety of water resources. Constructed wetlands (CWs) are a nature-based and low-cost solution to purify and remove cyanotoxins from water. However, bio-mechanistic understanding of the biotransformation processes expected to drive cyanotoxin removal in such systems is poor, and primarily focused on bacteria. Thus, the present study aimed at exploring the fungal contribution to microcystin-LR and cylindrospermopsin biodegradation in CWs. Based on CW mesocosms, two experimental approaches were taken: a) amplicon sequencing studies were conducted to investigate the involvement of the fungal community; and b) CW fungal isolates were tested for their microcystin-LR and cylindrospermopsin degradation capabilities. The data uncovered effects of seasonality (spring or summer), cyanotoxin exposure, vegetation (unplanted, Juncus effusus or Phragmites australis) and substratum (sand or gravel) on the fungal community structure. Additionally, the arbuscular mycorrhizal fungus Rhizophagus and the endophyte Myrmecridium showed positive correlations with cyanotoxin removal. Fungal isolates revealed microcystin-LR-removal potentials of approximately 25 % in in vitro biodegradation experiments, while the extracellular chemical fingerprint of the cultures suggested a potential intracellular metabolization. The results from this study may help us understand the fungal contribution to cyanotoxin removal, as well as their ecology in CWs.

Aplicativos móveis sobre segurança do paciente idoso no ambiente cirúrgico: uma prospecção tecnológica / Mobile applications on the safety of elderly patients in the surgical environment: a technological prospecting

OBJETIVO: Descrever os aplicativos voltados para a segurança do paciente idoso cirúrgico nos períodos pré e pós-operatório. MÉTODO: Prospecção tecnológica com abordagem qualitativa realizada nas lojas virtuais Apple Store, Google Play e aplicativo web. Como estratégia de busca utilizou-se os termos: 'autocuidado idoso', 'pré-operatório', 'pós-operatório', 'segurança do paciente', 'segurança do paciente idoso'. RESULTADOS: Foram identificados 12 aplicativos na loja virtual Apple Store, 17 na Google Play e um web app, os quais estavam voltados a gamificação de profissionais da saúde e da população; aplicativos educacionais aos profissionais de saúde e usuários do sistema de saúde; aplicativos relacionados como ferramenta de trabalho para os profissionais de saúde; aplicativos como ferramenta de autocuidado para usuários do sistema de saúde; e, aplicativos voltados para pós-operatório de usuários do sistema de saúde. CONCLUSÃO: Não foram encontradas tecnologias voltadas para o autocuidado e segurança do paciente idoso nos períodos pré e pós-operatório

OBJECTIVE: To describe applications focused on the safety of elderly surgical patients in the pre- and postoperative periods. METHOD: Technology prospecting with a qualitative approach in the Apple Store, Google Play virtual stores, and web application. As a search strategy, the following terms were used: 'elderly self-care', 'preoperative', 'postoperative', 'patient safety', 'elderly patient safety'. RESULTS: 12 applications were identified in the Apple Store, 17 in Google Play, and a web app, which focused on the gamification of health and population professionals; educational applications to health professionals and health system users; related applications as a work tool for health professionals; applications as a self-care tool for health system users; and, post-operative applications for health system users. CONCLUSION: Technologies aimed at self-care and the safety of elderly patients were not found in the pre- and postoperative periods.

Melhores práticas de enfermagem para a pessoa idosa em Unidades de Estratégia Saúde da Família em um município do Sul do país

Compreender as melhores práticas de enfermagem desempenhadas na Atenção Primária à Saúde em unidades de Estratégia Saúde da família em um município da região Norte do Estado de Santa Catarina. Método: pesquisa qualitativa realizada no município de Joinville­SC por meio de entrevistas semiabertas e individuais. Resultados: Participaram da pesquisa 30 enfermeiros atuantes na atenção primária. Descrevem as melhores práticas de enfermagem voltadas à pessoa idosa, com destaque para a resolubilidade das práticas, a priorização do acesso da pessoa idosa, o cuidado ampliado para os familiares, a atuação do enfermeiro frente a situações de negligência e violência contra a pessoa idosa e, ainda, as barreiras para a efetivação das melhores práticas. Conclusão: a qualificação das ações oferecidas as pessoas idosas na atenção primária perpassa questões administrativas, sociais e resolutivas, e exigem que o enfermeiro esteja inserido no território, conhecendo potencialidades e limitações que interferem no planejamento do cuidado. Contudo, somente enfermeiros com autonomia e segurança no saber científico, aliado ao apoio institucional e ambiente adequado, desenvolvem melhores práticas.

Modulation of the activation of endothelial nitric oxide synthase and nitrosative stress biomarkers by aspirin triggered lipoxins: A possible mechanism of action of aspirin in the antiphospholipid syndrome.

PROBLEM: Antiphospholipid syndrome (APS) is characterized by the clinical manifestation of vascular thrombosis (VT) or pregnancy morbidity (PM) and antiphospholipid antibodies (aPL) that can modify the nitric oxide production. Low-dose aspirin is used in the prevention and treatment of diverse alterations of pregnancy. One of the mechanisms of action of aspirin is to induce the production of aspirin-triggered-lipoxins (ATL). The aim of this study was to evaluate the modulatory effect of ATL over the activation of endothelial nitric oxide synthase (eNOS) and nitrosative stress biomarkers induced by aPL. METHODS: We used polyclonal IgG and sera from women with aPL and PM/VT or VT only, and from women with PM only and positive for non-criteria aPL (SN-OAPS). In these sera, biomarkers of nitrosative stress (nitrites and nitrotyrosine) were measured. The protein expression of nitrotyrosine and the phosphorylation of eNOS (at Ser1177) were estimated in human umbilical vein endothelial cells (HUVECs) stimulated with polyclonal IgG with or without ATL. RESULTS: Women with SN-OAPS showed increased circulating levels of nitrites and nitrotyrosine. Likewise, polyclonal IgG from either SN-OAPS or VT patients stimulated nitrotyrosine expression in HUVECs. ATL decreased the nitrotyrosine expression induced by polyclonal IgG from the SN-OAPS group. ATL also recovered the reduced eNOS phosphorylation at Ser1177 in HUVECs stimulated with polyclonal IgG from women with PM/VT or SN-OAPS. CONCLUSIONS: Increased nitrosative stress present in serum of women with SN-OAPS is associated with IgG-mediated impaired endothelial NO synthesis in endothelial cells. ATL prevent these cellular changes.

From gut to placenta: understanding how the maternal microbiome models life-long conditions.

The microbiome -defined as the microbiota (bacteria, archaea, lower and higher eukaryotes), their genomes, and the surrounding environmental conditions- has a well-described range of physiological functions. Thus, an imbalance of the microbiota composition -dysbiosis- has been associated with pregnancy complications or adverse fetal outcomes. Although there is controversy about the existence or absence of a microbiome in the placenta and fetus during healthy pregnancy, it is known that gut microbiota can produce bioactive metabolites that can enter the maternal circulation and may be actively or passively transferred through the placenta. Furthermore, the evidence suggests that such metabolites have some effect on the fetus. Since the microbiome can influence the epigenome, and modifications of the epigenome could be responsible for fetal programming, it can be experimentally supported that the maternal microbiome and its metabolites could be involved in fetal programming. The developmental origin of health and disease (DOHaD) approach looks to understand how exposure to environmental factors during periods of high plasticity in the early stages of life (e.g., gestational period) influences the program for disease risk in the progeny. Therefore, according to the DOHaD approach, the influence of maternal microbiota in disease development must be explored. Here, we described some of the diseases of adulthood that could be related to alterations in the maternal microbiota. In summary, this review aims to highlight the influence of maternal microbiota on both fetal development and postnatal life, suggesting that dysbiosis on this microbiota could be related to adulthood morbidity.

Paracoccidioidomycosis with digestive manifestations in a pediatric patient.

BACKGROUND: Paracoccidioidomycosis is a systemic infection caused by the fungus Paracoccidioides. It may present in two forms: an acute/subacute form, whose most frequent manifestations include weight loss, fever, anemia, and adenopathy, and a chronic condition with mainly respiratory symptoms. Digestive symptoms, although they may occur, are not frequently reported. Paracoccidioidomycosis usually affects adult male agricultural workers; thus, its presentation in children is rare. CASE REPORT: We describe the case of a 9-year-old male patient diagnosed with paracoccidioidomycosis, who showed abdominal pain and diarrhea as initial manifestations of the disease. CONCLUSIONS: This case is reported not only because of the age of presentation but also due to the existence of digestive symptoms from the onset of the disease, both infrequently reported in the literature.

INTRODUCCIÓN: La paracoccidioidomicosis es una infección sistémica producida por el hongo Paracoccidioides. Se puede presentar de dos formasuna forma aguda/subaguda, cuyas manifestaciones más frecuentes incluyen pérdida de peso, fiebre, anemia y adenopatías, y una forma crónica con manifestaciones principalmente respiratorias. Las manifestaciones digestivas, aunque pueden presentarse, no se reportan frecuentemente. La paracoccidioidomicosis afecta usualmente a varones adultos que trabajan en labores agrícolas, por lo que su presentación en niños es poco frecuente. CASO CLÍNICO: Se describe el caso de un paciente de sexo masculino de 9 años de edad con diagnóstico de paracoccidioidomicosis, con dolor abdominal y diarrea como manifestaciones iniciales de la enfermedad. CONCLUSIONES: Se reporta este caso, no solamente por la edad de presentación, sino también por la existencia de síntomas digestivos desde el inicio de la enfermedad, ambos reportados en forma infrecuente en la literatura.

Paracoccidioidomycosis with digestive manifestations in a pediatric patient / Paracoccidioidomicosis con manifestaciones digestivas en un paciente pediátrico

Abstract Background: Paracoccidioidomycosis is a systemic infection caused by the fungus Paracoccidioides. It may present in two forms: an acute/subacute form, whose most frequent manifestations include weight loss, fever, anemia, and adenopathy, and a chronic condition with mainly respiratory symptoms. Digestive symptoms, although they may occur, are not frequently reported. Paracoccidioidomycosis usually affects adult male agricultural workers; thus, its presentation in children is rare. Case report: We describe the case of a 9-year-old male patient diagnosed with paracoccidioidomycosis, who showed abdominal pain and diarrhea as initial manifestations of the disease. Conclusions: This case is reported not only because of the age of presentation but also due to the existence of digestive symptoms from the onset of the disease, both infrequently reported in the literature.

Resumen Introducción: La paracoccidioidomicosis es una infección sistémica producida por el hongo Paracoccidioides. Se puede presentar de dos formasuna forma aguda/subaguda, cuyas manifestaciones más frecuentes incluyen pérdida de peso, fiebre, anemia y adenopatías, y una forma crónica con manifestaciones principalmente respiratorias. Las manifestaciones digestivas, aunque pueden presentarse, no se reportan frecuentemente. La paracoccidioidomicosis afecta usualmente a varones adultos que trabajan en labores agrícolas, por lo que su presentación en niños es poco frecuente. Caso clínico: Se describe el caso de un paciente de sexo masculino de 9 años de edad con diagnóstico de paracoccidioidomicosis, con dolor abdominal y diarrea como manifestaciones iniciales de la enfermedad. Conclusiones: Se reporta este caso, no solamente por la edad de presentación, sino también por la existencia de síntomas digestivos desde el inicio de la enfermedad, ambos reportados en forma infrecuente en la literatura.

Mentalidad machista, estilos de crianza y vulnerabilidad social en cuidadores primarios. Una comparación transcultural entre Argentina y Perú / Sexist mentality, parenting styles and social vulnerability in primary caregivers. A cross-cultural comparison between Argentina and Peru

Resumen Introducción: la mentalidad machista es un fenómeno persistente en Latinoamérica. Sin embargo, no se tienen claros los factores que la generan, por ello, se realizó el estudio para analizar la mentalidad machista en función de factores como los estilos parentales y la vulnerabilidad social. Método: la muestra estuvo constituida por 389 (M.edad = 35.87, DE = 10.13) cuidadores primarios de niños, niñas y adolescentes de 4-16 años (M.edad= 9.33, DE = 4.66, femenino = 196) de diferentes regiones de Perú y Argentina. Se utilizaron (a) la subescala de Machismo de la Evaluación Multifásica de las Culturas (MACC-SF), (b) la Adaptación Española del Cuestionario de Crianza Parental y (c) una ficha sociodemográfica ad hoc, aplicadas través de las redes sociales mediante un formulario. Resultados: en ambas muestras, los niveles de machismo son relativamente bajos, aunque la muestra argentina presentó menores niveles y hábitos más positivos de crianza, en comparación con Perú. A su vez, se encontró asociación negativa entre machismo y estilos parentales, con mayor intensidad en las dimensiones; satisfacción con la crianza y disciplina. Finalmente, el machismo se asoció de forma negativa con la vulnerabilidad social y los estilos de crianza. Conclusión: las creencias machistas estarían asociadas con menor nivel socioeconómico y estilos de crianza más autoritarios, los que también se rigen por sus tradiciones y a un conservadurismo del legado cultural, en comparación a culturas más flexibles y democráticas.

Abstract Introduction: the macho mentality is a phenomenon that persists in the Latin American population; however, the factors that generate it are not clear. Therefore, the study is carried out with the objective of analyzing the macho mentality, based on factors such as parental styles and social vulnerability; and comparing according to country of origin: Argentina and Peru, respectively. Method: the sample consisted of 389 (M.age = 35.87, SD = 10.13) primary caregivers of children and adolescents from 4 to 16 (M.age = 9.33, SD = 4.66, feminine = 196) years of age from different regions of Peru and Argentina. The instruments used were the Machismo subscale of the Multiphasic Evaluation of Cultures (MACC-SF), the Spanish Adaptation of the Parental Upbringing Questionnaire, and an ad-hoc sociodemographic record, which were all applied through social networks using a Google® form. Results: in both samples, the levels of machismo are relatively low, although the Argentine sample presented lower levels of machismo and more positive parenting habits compared to that of Peru. In turn, a negative association was found between machismo and parenting styles, with greater intensity in the dimensions: satisfaction with parenting and discipline. Finally, machismo was negatively associated with social vulnerability and parenting styles. Conclusions: macho beliefs would be associated with a lower socioeconomic level and more authoritarian and inflexible parenting styles, which are also governed by their traditions and a cultural legacy of conservatism in comparison to more flexible and democratic cultures.

Losac and Lopap Recombinant Proteins from Lonomia obliqua Bristles Positively Modulate the Myoblast Proliferation Process.

The pursuit of better therapies for disorders creating deficiencies in skeletal muscle regeneration is in progress, and several biotoxins are used in skeletal muscle research. Since recombinant proteins derived from Lonomia obliqua bristles, recombinant Lonomia obliqua Stuart-factor activator (rLosac) and recombinant Lonomia obliqua prothrombin activator protease (rLopap) act as cytoprotective agents and promote cell survival, we hypothesize that both rLosac and rLopap favour the skeletal muscle regeneration process. In the present work, we investigate the ability of these recombinant proteins rLosac and rLopap to modulate the production of key mediators of the myogenic process. The expression of myogenic regulatory factors (MRFs), cell proliferation, the production of prostaglandin E2 (PGE2) and the protein expression of cyclooxygenases COX-1 and COX-2 were evaluated in C2C12 mouse myoblasts pre-treated with rLosac and rLopap. We found an increased proliferation of myoblasts, stimulated by both recombinant proteins. Moreover, these proteins modulated PGE2 release and MRFs activities. We also found an increased expression of the EP4 receptor in the proliferative phase of C2C12 cells, suggesting the involvement of this receptor in the effects of PGE2 in these cells. Moreover, the recombinant proteins inhibited the release of IL-6 and PGE2, which is induced by an inflammatory stimulus by IL-1ß. This work reveals rLopap and rLosac as promising proteins to modulate processes involving tissue regeneration as occurs during skeletal muscle injury.

Advanced Practice Nursing in Brazil: how are we and what is missing?

OBJECTIVE: To reflect on the role and initiatives of the Brazilian Nursing Association (ABEn) and the Federal Nursing Council (Cofen) in the development, recognition, and regulation necessary to implement advanced practice nursing (APN) in Brazil. METHOD: This is a theoretical-reflective essay resulting from the roundtable discussion entitled "Regulation and recognition of advanced nursing practices in Brazil: how are we and what is missing" held in May 2021, at the III International Symposium on Adult Health. RESULTS: ABEn and Cofen are strategic partners to define the areas of activity of this specialization in Brazil. Nursing organizations are responsible for defining professional profiles and curricula, advanced practice nursing conditions, and adequacy of existing graduate courses aiming at technical support, political leadership, regulation, and construction of an APN foundation in Brazil. CONCLUSION: Brazil must broaden the national debate on APN, define a training model for it, and articulate efforts with all its strategic partners to build a theoretical, political, and labor framework for advanced practice nurses' full professional practice.

Myiasis by Cordylobia anthropophaga (Calliphoridae) in rodents from Cape Verde.

PURPOSE: The tumbu fly, Cordylobia anthropophaga (Diptera: Calliphoridae), is widely distributed in continental tropical and subtropical Africa, being the most common cause of furuncular myiasis in Sub-Saharan Africa. The aim of the present work was to analyze the role of rodents as possible reservoirs of C. anthropophaga in Cape Verde, considering the zoonotic character of this fly species. MATERIALS AND METHODS: A total of 150 peridomestic rodents were studied in Santiago island. For the obtained larvae, morphological and molecular characters were analyzed. RESULTS: Cordylobia anthropophaga was found in 6.4% of the peridomestic Rattus rattus analyzed. The present work unveils the presence of C. anthropophaga in rodents of the African archipelago of Cape Verde, introduced probably with West African humans and/or animals. CONCLUSION: The presence in peridomestic animals, and the wide range of species that this fly can affect, entails a zoonotic risk of myiasis by tumbu fly.

Parkinson's disease in primary health care and nursing care: a scoping review.

OBJECTIVE: to map and analyze the scientific literature on nursing care aimed at people with Parkinson's disease in Primary Health Care. METHOD: this is a scoping review using the Joanna Briggs Institute methodology, carried out between July and October 2020, and updated in November 2021 in six databases from nursing care and Parkinson's disease descriptors, and their respective acronyms and synonyms in English, Portuguese and Spanish. RESULTS: a total of 44 publications were included in this review, which identified as nursing care in Primary Care: assessment of motor and non-motor functions; management of activities of daily living and instrumental activities of daily living; disease self-management education for people with Parkinson's and their care partners; supervised group approach; and personal factor management. CONCLUSION: Nursing care for people with Parkinson's at the primary level essentially involves actions that include providing focused care at an individual and group level, encompassing clinical assessment, patient education, patient involvement in the social context of care, and developing positive relationships with family members and caregivers.

Sensitization during short-term mechanical circulatory support. Determinants, therapeutic management, and outcomes after heart transplant.

INTRODUCTION AND OBJECTIVES: The development of human-leukocyte antigen antibodies is a well-known adverse effect of the use of long-term ventricular assist devices (VADs). The aim of this study was to determine the incidence of sensitization during short-term mechanical circulatory support with VAD (CentriMag), its determinants, and its impact on posttransplant outcomes. METHODS: We performed a retrospective review of patients who were bridged to transplant with short-term VAD from 2009 to 2019. Sensitization was defined as a calculated panel-reactive antibody> 10%. The endpoints included overall survival and rejection-free survival. RESULTS: A total of 89 patients (median age 56.0 [interquartile range, 50.0-59.9] years, 16.8% female) received a short-term VAD as a bridge to transplant. The median duration of support was 23.6 [interquartile range, 16.6-35.0] days. Eleven patients (12.4%) became sensitized during support. The only factor significantly associated with sensitization was female sex (OR, 8.67; 95%CI, 1.93-38.8; P=.005). Of the 89 patients, 21 patients died during support; 68 patients underwent heart transplant. After a mean follow-up of 49.6 ±31.2 months, 8 patients (11.8%) died and 20 (29.4%) had at least 1 rejection episode. On multivariate analysis, sensitization was an independent predictor of acute rejection (HR, 3.64; 95%CI, 1.42-9.33; P=.007), with a nonstatistically significant trend to higher mortality (HR, 4.07; 95%CI, 0.96-17.3; P=.057). CONCLUSIONS: Sensitization with short-term VADs can occur and is significantly associated with female sex and with rejection. Sensitization also showed a nonstatistically significant trend to higher mortality.

Cryptosporidium spp. in wild murids (Rodentia) from Corsica, France.

Cryptosporidium spp. are worldwide protozoan parasites that can affect to a broad range of vertebrate hosts, including rodents. In the island of Corsica (France), there are no previous data about these protozoa infecting wild rodents. To estimate the distribution and occurrence, a total of 117 wild murine rodents of the species Rattus rattus (84), Mus musculus domesticus (21), Apodemus sylvaticus (11), and Rattus norvegicus (1) were captured in 24 different biotopes. Fecal samples were screened for Cryptosporidium spp. by nested PCR to amplify an 830 bp fragment of the 18S rRNA gene. As general occurrence, 15.4% of the rodents analyzed were positive for Cryptosporidium spp., being detected widely distributed along the island in R. rattus (17.6%) and M. m. domesticus (14.3%). Cryptosporidium viatorum, Cryptosporidium sp. rat genotype II, and Cryptosporidium sp. rat genotype III were successfully identified in R. rattus. The results herein reported provide the first data on Cryptosporidium spp. in wild murine species from a Mediterranean island and constitute the first report of the zoonotic species C. viatorum in R. rattus. Although a low occurrence of Cryptosporidium spp. in murids was obtained and only in one animal the zoonotic species C. viatorum was identified, our results highlight that wild murine rodents from Corsica could mediate in the maintenance and transmission of this protozoan to the environment and other hosts including humans and animals. Further studies are required to better understand the epidemiology of Cryptosporidium spp. in wild rodents from Corsica and their possible public health repercussions.

Avaliação do risco de quedas entre pessoas com doença de Parkinson / Evaluación del riesgo de caídas en personas con enfermedad de Parkinson / Assessment of risk of falls in people with Parkinson's disease

RESUMO Objetivo identificar os fatores associados ao risco de quedas entre as pessoas com doença de Parkinson cadastradas na Associação Parkinson Santa Catarina. Método estudo transversal exploratório descritivo e de abordagem quantitativa, realizado com 53 pessoas cadastradas na Associação Parkinson Santa Catarina, no município de Florianópolis, Brasil, no período de junho a setembro de 2019. Foram aplicados questionário sociodemográfico, Escala de Hoehn e Yahr, Mini Exame do Estado Mental e Teste de Rastreio do Risco de Queda no Idoso. Os dados foram tabulados e analisados por meio do Sistema online de Ensino-Aprendizagem de Estatística SEstatNet®. Resultados foram identificados fatores de risco, como sexo, aumento da idade, redução da força muscular, instabilidade postural e diminuição da velocidade da marcha. Em relação aos estágios da doença, foi constatado que em todos houve piora da velocidade da marcha e o medo de cair é constante, aumentando com o agravamento da doença e o tempo de diagnóstico. Conclusão e implicações para a prática ao aprofundar o estudo do tema, o enfermeiro consegue compreender os acometimentos motores que levam à fragilização e à queda em pessoas com doença de Parkinson, elaborando estratégias para preveni-las.

RESUMEN Objetivo identificar los factores asociados al riesgo de caídas en personas con enfermedad de Parkinson registradas en la Asociación de Parkinson Santa Catarina. Método estudio descriptivo exploratorio transversal, con abordaje cuantitativo realizado con 53 personas registradas en la Asociación Parkinson Santa Catarina, en la ciudad de Florianópolis, Brasil, de junio a septiembre de 2019. Se aplicaron un cuestionario sociodemográfico, la Escala de Hoehn y Yahr, el Mini Examen del Estado Mental y la Prueba de Detección del Riesgo de Caídas en Ancianos. Los datos se tabularon y analizaron utilizando el Sistema en línea de enseñanza-aprendizaje de estadísticas SEstatNet®. Resultados se identificaron factores de riesgo como sexo, mayor edad, disminución de la fuerza muscular, inestabilidad postural y disminución de la velocidad de la marcha. En cuanto a las etapas de la enfermedad, se encontró que en todas ellas se produjo un empeoramiento de la velocidad de la marcha y el miedo a caer es constante, aumentando con el empeoramiento de la enfermedad y el momento del diagnóstico. Conclusión e implicaciones para la práctica al profundizar en el estudio del tema, el enfermero es capaz de comprender las deficiencias motoras que conducen a la fragilidad y caída en personas con enfermedad de Parkinson, ideando estrategias para prevenirlas.

ABSTRACT Objective to identify the factors associated with risk of falls among people with Parkinson's disease registered at the Parkinson Santa Catarina Association. Method this is a cross-sectional exploratory descriptive study with a quantitative approach, carried out with 53 people registered at the Parkinson Santa Catarina Association, in the city of Florianópolis, Brazil, from June to September 2019. Sociodemographic questionnaire, Hoehn and Yahr scale, Mini Mental State Examination and Simple Screening Test for Risk of Falls in the Elderly were applied. The data were tabulated and analyzed using the SEstatNet® Statistics Teaching-Learning Online System. Results risk factors were identified, such as sex, increased age, reduced muscle strength, postural instability and decreased gait speed. Regarding the stages of the disease, it was found that in all of them there was a worsening of gait speed and the fear of falling is constant, increasing with the worsening of the disease and diagnosis time. Conclusion and implications for practice by deepening the study of the topic, nurses are able to understand the motor impairments that lead to frailty and fall in people with Parkinson's disease, developing strategies to prevent them.

O enfermeiro no cuidado à pessoa idosa: construção do vínculo na atenção primária à saúde / El enfermero en el cuidado al adultomayor: construcción del vínculo en la atención primaria de salud / Nurses in the care of older adults: building a bond in primary health care

RESUMO Objetivo: compreender como o enfermeiro na Estratégia de Saúde da Família constrói o vínculo profissional com a pessoa idosa. Métodos: pesquisa qualitativa, com 30 enfermeiros de Estratégias de Saúde da Família de Joinville, entrevistados entre janeiro e março de 2018. Foi utilizado um instrumento de entrevista semiestruturado. Os dados foram analisados conforme a análise de conteúdo temática. Resultados: os resultados que emergiram das categorias apontam a importância de reconhecer o território de atuação, aprimorar a escuta sensível para questões do envelhecimento, valorizar a individualidade da pessoa idosa e seu contexto, a necessidade de trabalhar com parcerias intersetoriais e entre a equipe multiprofissional realizando atividades coletivas de promoção e prevenção da saúde, visando a qualidade no cuidado e, esse modo de trabalho possibilita que os enfermeiros tornem-se protagonistas, referências no cuidar, otimizando a construção e o fortalecimento de vínculo com as pessoas idosas e equipe o que pode proporcionar maior adesão a estilos de vida saudáveis e ao tratamento de saúde. Considerações finais: os enfermeiros estão imersos a um processo de construção de vínculo em suas unidades, são protagonistas, referência para sua equipe e para pessoa idosa. No entanto, há que se perfazer um longo caminho até que essas habilidades estejam de acordo ao que se postula como melhores práticas de enfermagem.

RESUMEN Objetivo: comprender cómo el enfermero en la Estrategia de Salud de la Familia construye el vínculo profesional con el adulto mayor. Métodos: investigación cualitativa, con 30 enfermeros de Estrategias de Salud de la Familia de Joinville, entrevistados entre enero y marzo de 2018. Se utilizó un instrumento de entrevista semiestructurado. Los datos fueron analizados según el análisis de contenido temático. Resultados: los resultados que surgieron de las categorías señalan la importancia de reconocer el territorio de actuación, mejorar la escucha sensible para cuestiones del envejecimiento, valorar la individualidad del adulto mayor y su contexto, la necesidad de trabajar con alianzas intersectoriales y entre el equipo multiprofesional, realizando actividades colectivas de promoción y prevención de la salud, buscando la calidad en el cuidado y, ese modo de trabajo posibilita que los enfermeros se vuelvan protagonistas, referencias en el cuidado, optimizando la construcción y el fortalecimiento de vínculo con los adultos mayores y el equipo que puede proporcionar mayor adhesión a estilos de vida saludables y al tratamiento de salud. Consideraciones finales: los enfermeros están inmersos en un proceso de construcción de vínculo en sus unidades, son protagonistas, referencia para su equipo y para la persona anciana. Sin embargo, hay que hacer un largo camino hasta que esas habilidades estén de acuerdo con lo que se postula como mejores prácticas de enfermería.

ABSTRACT Objective: tounderstand how Family Health Strategy nurses build a bond with older adults. Methods: qualitative research, with 30 nurses from the Family Health Strategies of Joinville, interviewed between January and March 2018. A semi-structured interview instrument was used. Data were analyzed according to thematic content analysis. Results: the results that emerged from the categories point to the importance of recognizing the territory of action, improving sensitive listening to aging issues, valuing the individuality of older adults and their context, the need to work with intersectoral partnerships and among the multidisciplinary team, carrying out collective health promotion and prevention activities, aiming at quality in care. This way of working allows nurses to become leaders, references in care, optimizing the building and strengthening of bonds with older adults and the team, which can provide greater adherence to healthy lifestyles and health care. Final considerations: nurses are immersed in a process of building a bond in their units, they are leaders, a reference for their team and for older adults. However, there is still a long way to go before these skills are in line with what is postulated as nursing best practices.

Parkinson's disease in primary health care and nursing care: a scoping review / Enfermedad de parkinson en atención primaria de salud y cuidados de enfermería: revisión del alcance / Doença de parkinson na atenção primária à saúde e o cuidado de enfermagem: revisão de escopo

ABSTRACT Objective: to map and analyze the scientific literature on nursing care aimed at people with Parkinson's disease in Primary Health Care. Method: this is a scoping review using the Joanna Briggs Institute methodology, carried out between July and October 2020, and updated in November 2021 in six databases from nursing care and Parkinson's disease descriptors, and their respective acronyms and synonyms in English, Portuguese and Spanish. Results: a total of 44 publications were included in this review, which identified as nursing care in Primary Care: assessment of motor and non-motor functions; management of activities of daily living and instrumental activities of daily living; disease self-management education for people with Parkinson's and their care partners; supervised group approach; and personal factor management. Conclusion: Nursing care for people with Parkinson's at the primary level essentially involves actions that include providing focused care at an individual and group level, encompassing clinical assessment, patient education, patient involvement in the social context of care, and developing positive relationships with family members and caregivers.

RESUMEN Objetivo: mapear y analizar la literatura científica sobre el cuidado de enfermería dirigido a personas con enfermedad de Parkinson en la Atención Primaria de Salud. Método: una revisión del alcance utilizando la metodología del Joanna Briggs Institute, realizada entre julio y octubre de 2020, y actualizada en noviembre de 2021 en seis bases de datos, de los descriptores cuidado de enfermería y enfermedad de Parkinson, y sus respectivas siglas y sinónimos en inglés, portugués y español. Resultados: en esta revisión se incluyeron 44 publicaciones, que identificaron como cuidados de enfermería en Atención Primaria: evaluación de las funciones motoras y no motoras; gestión de Actividades de la Vida Diaria y Actividades Instrumentales de la Vida Diaria; educación para el autocontrol de enfermedades para personas con Parkinson y sus cuidadores; enfoque de grupo supervisado; y manejo de factores personales. Conclusión: la atención de enfermería a las personas con Parkinson en el nivel primario implica esencialmente acciones que incluyen brindar cuidados enfocados a nivel individual y grupal, incluyendo la evaluación clínica, educación del paciente, participación del paciente en el contexto social de la atención y desarrollo de relaciones positivas con los miembros de la familia y los cuidadores.

RESUMO Objetivo: mapear e analisar a literatura científica acerca dos cuidados de enfermagem direcionados às pessoas com doença de Parkinson na Atenção Primária à Saúde. Método: revisão de escopo utilizando a metodologia do Joanna Briggs Institute, realizada entre julho e outubro de 2020, e atualizada em novembro de 2021 em seis bases de dados, a partir dos descritores cuidados de enfermagem e doença de Parkinson, e seus respectivos acrônimos e sinônimos em inglês, português e espanhol. Resultados: foram incluídas 44 publicações nesta revisão, que identificaram como cuidados de enfermagem na Atenção Primária: avaliação das funções motoras e funções não motoras; gerenciamento das Atividades de Vida Diária e das Atividades Instrumentais de Vida Diária; educação para autogestão da doença para pessoas com Parkinson e seus parceiros de cuidado; abordagem supervisionada em grupo; e gerenciamento dos fatores pessoais. Conclusão: os cuidados de enfermagem à pessoa com Parkinson no âmbito primário envolvem, essencialmente, ações que incluem prestar cuidados centrados em nível individual e em grupo, abrangendo avaliação clínica, educação do paciente, envolvimento deste no contexto social do cuidado e desenvolvimento de relacionamentos positivos com os familiares e cuidadores.