Community-Based Action Research Intervention to Promote Occupational Health Nursing of Portuguese Quarry Workers.

The northern region of Portugal has the largest number of companies manufacturing granite and stone products, which has become the region's trademark. In the municipalities of Marco de Canaveses and Penafiel, the economic activity of this area is important. However, the lack of attractiveness of this activity, combined with the high prevalence of silicosis and tuberculosis in this population, has led to a growing shortage of labor. In order for this project to be the result of collaborative, integral work centered on the people who are the target of health promotion, we used the Participatory Health Research (PHR) approach, based on the PRECEDE-PROCEED model, to implement a mixed-methods study, including participant observation, interviews and document analysis. These data were used to co-create a study design. In 2021, a total of 102 interviews were carried out and self-completion surveys were distributed: the Fantastic Lifestyle Questionnaire (FLQ) and the EQ-5D-3L. Within the scope of occupational health nursing and in the field of action of public health nurses, with the interviews and self-completed surveys carried out, we identified potential focuses for occupational health nursing intervention to promote the health of stone industry workers: adherence to protective measures, energy balance deficit, tobacco and alcohol consumption and access to health services. Data analysis made it possible to assess the prevalence of risk behaviors by order and to involve managers and workers in the co-creation of a health promotion program. The accurate identification of the focuses for nursing intervention not only improves the effectiveness of occupational health services, allowing for targeted interventions adapted to workers' needs, but also contributes considerably to health promotion in the workplace, resulting in safer working environments, a reduction in occupational diseases and, consequently, a healthier and more productive workforce. This protocol of this study was not registered.

Modelo PRECEDE-PROCEED como ferramenta para diagnósticos social e epidemiológico de trabalhadores da saúde com COVID-19 / PRECEDE-PROCEED model as a tool for social and epidemiological diagnoses of health workers with COVID-19 / Modelo PRECEDE-PROCEED como herramienta para el diagnóstico social y epidemiológico de los trabajadores de la salud con COVID-19

Objetivo: evidenciar os diagnósticos social e epidemiológico de trabalhadores da saúde atuantes na pandemia e acometidos por COVID-19, aplicando modelo PRECEDE-PROCEED. Métodos: estudo documental, quantitativo, observacional, retrospectivo, desenvolvido a partir do modelo PRECEDE-PROCEED, que norteia intervenções, partindo do diagnóstico faseado para implementar ações. Dados obtidos em 215 prontuários de trabalhadores com COVID-19, atendidos no serviço ocupacional hospitalar em Macapá, entre 2020 e 2021. Resultados: diagnóstico social: mulheres (81,9%), pardas/pretas (79%), idade entre 40/55 anos (53,4%), técnicas de enfermagem (40%), da nefrologia (10,2%), vínculo estadual/federal (91,6%) superior a 10 anos (60,4%). Diagnóstico Epidemiológico: cefaleia (53,5%), tosse (51,6%), febre (47,9%). Teste rápido (76,3%), atendimento ambulatorial (90,2%), afastamento de 8 a 14 dias (45,1%), 100% curados, sequelas em 12,6%. Sem diferença significativa quanto ao afastamento por função exercida. Dispneia, dor torácica e sequelas da doença tem maior chance de afastamento. Conclusão: a aplicação do modelo possibilita planejar ações de conscientização/prevenção sobre risco, adoecimento, acidente laboral e cuidados à saúde dos trabalhadores.

Objective: to highlight the social and epidemiological diagnoses of health workers working in the pandemic and affected by COVID-19, applying the PRECEDE-PROCEED model. Methods: documentary, quantitative, observational, retrospective study, developed based on the PRECEDE-PROCEED model, which guides interventions, starting from phased diagnosis to implement actions. Data obtained from 215 medical records of workers with COVID-19, treated at the hospital occupational service in Macapá, between 2020 and 2021. Results: social diagnosis: women (81.9%), brown/black (79%), aged between 40/ 55 years old (53.4%), nursing technicians (40%), nephrology (10.2%), state/federal employment (91.6%) for more than 10 years (60.4%). Epidemiological Diagnosis: headache (53.5%), cough (51.6%), fever (47.9%). Rapid test (76.3%), outpatient care (90.2%), sick leave of 8 to 14 days (45.1%), 100% cured, sequelae in 12.6%. No significant difference in terms of leave by function performed. Dyspnea, chest pain and sequelae of the disease have a greater chance of sick leave. Conclusion: the application of the model makes it possible to plan awareness/prevention actions regarding risk, illness, occupational accidents and workers' health care.

Objetivo: visibilizar los diagnósticos social y epidemiológico de los trabajadores de la salud que trabajan en la pandemia y afectados por el COVID-19, aplicando el modelo PRECEDE-PROCEED. Métodos: estudio documental, cuantitativo, observacional, retrospectivo, desarrollado con base en el modelo PRECEDE-PROCEED, que orienta las intervenciones, a partir del diagnóstico por fases para implementar de acciones. Los datos se obtuvieron de 215 historias clínicas de trabajadores con COVID-19, atendidos en el servicio ocupacional hospitalario de Macapá, entre 2020 y 2021. Resultados: diagnóstico social: mujeres (81,9%), morenas/negras (79%), edades entre 40/ 55 años (53,4%), técnicos en enfermería (40%), del área de nefrología (10,2%), empleo estatal/federal (91,6%) con más de 10 años (60,4%). Diagnóstico Epidemiológico: dolor de cabeza (53,5%), tos (51,6%), fiebre (47,9%). Prueba rápida (76,3%), atención ambulatoria (90,2%), baja laboral de 8 a 14 días (45,1%), 100% curados, secuelas en un 12,6%. No hay diferencia significativa en términos de licencias por función desempeñada. La disnea, el dolor torácico y las secuelas de la enfermedad tienen mayor probabilidad de ocasionar la baja laboral. Conclusiones: la aplicación del modelo permite planificar acciones de concienciación/prevención en cuanto al riesgo, enfermedades, accidentes laborales y atención de la salud de los trabajadores.

Estilos de vida dos estudantes do ensino superior: Contributos para a promoção da saúde / Higher education students' lifestyles: Contributions to health promotion / Estilos de vida de los estudiantes de educación superior: Contribuciones a la promoción de la salud

Resumo Enquadramento: A transição para o ensino superior representa um período de mudança em que o jovem se depara com novas vivências, com implicações no seu estilo de vida. Objetivo: Identificar os domínios dos Estilos de vida dos estudantes do ensino superior que necessitam de intervenção. Metodologia: Estudo descritivo-correlacional, transversal, com uma amostra de 522 estudantes do ensino superior. Questionário de Estilos de Vida Fantástico. Análise estatística em IBM SPSS Statistics 25.0. Resultados: Mediana de idade 22 anos, 78,4% sexo feminino. Dos 522 estudantes, 17,8% excesso peso; 6,3 % obesidade; 14.4% portadores de doença crónica; 35,6% apresentaram Estilos de Vida Muito Bom e 20,1% Estilos de Vida Bom. Destacou-se pela negativa Comportamentos Saúde e Sexual (x-= 8,97/24), Trabalho/Tipo Personalidade (x-= 6,82/12). Há diferenças significativas no score global do questionário (U = 19785,00; p < 0,05) para estudantes as mulheres com melhor Estilo de Vida (x-= 89,16; DP = 12,75); e em função Ano do curso (H = 18,80; p < 0,01). Conclusão: A avaliação dos Estilos de Vida permitiu caraterizar os focos de intervenção e orientar intervenções de promoção da saúde.

Abstract Background: The transition to higher education is a period of change during which students have new experiences that influence their lifestyles. Objective: To identify the domains of higher education students' lifestyles that require intervention. Methodology: This cross-sectional descriptive correlational study was conducted with 522 higher education students. The Fantastic Lifestyle Assessment questionnaire was used, and statistical analysis was conducted using the IBM SPSS Statistics software - version 25.0. Results: The study participants had a median age of 22, and 78.4% were women. Of the 522 students in the sample, 17.8% were overweight and 6.3% were obese, 14.4% were diagnosed with a chronic disease, 35.6% had Very Good lifestyles, and 20.1% had Good lifestyles. The domains Health and sexual behavior (x-= 8.97/24) and Work/type of personality (x-= 6.82/12) obtained negative scores. Significant differences were found in the questionnaire's total score (U =19785.00; p < 0.05) when considering the variables Gender, with female students having better lifestyles (x-= 89.16; SD = 12.75) and Course year (H = 18.80; p < 0.01). Conclusion: Assessing higher education students' lifestyles offers the possibility to describe the intervention foci and guide the health promotion interventions.

Resumen Marco contextual: La transición a la enseñanza superior representa un periodo de cambio en el que los jóvenes se enfrentan a nuevas experiencias con implicaciones para su estilo de vida. Objetivo: Identificar los dominios de los estilos de vida de los estudiantes de enseñanza superior que necesitan intervención. Metodología: Estudio descriptivo-correlacional, transversal, muestra de 522 estudiantes de enseñanza superior. Cuestionario de estilos de vida Fantástico. Análisis estadístico en IBM SPSS Statistics 25.0. Resultados: Mediana de edad de 22 años, el 78,4% del sexo femenino. De los 522 estudiantes, el 17,8% con exceso de peso; el 6,3 % con obesidad; el 14.4% con una enfermedad crónica; el 35,6% presentó estilos de vida muy bueno, y el 20,1% estilos de vida bueno. Salud y comportamento sexual destacó negativamente (x-= 8,97/24), Trabajo/Tipo Personalidad (x-= 6,82/12). Existen diferencias significativas en la puntuación global del cuestionario (U = 19785,00; p < 0,05) para estudantes mujeres con un mejor estilo de vida (x-= 89,16; DP = 12,75) y dependiendo del año del curso (H = 18,80; p < 0,01). Conclusión: La evaluación de estilos de vida permitió caracterizar los focos de intervención y orientar las intervenciones de promoción de la salud.

Notificação da COVID-19 como acidente laboral por trabalhadores da saúde: scoping review / Notification of COVID-19 as an occupational injury by health workers: scoping review / Notification of COVID-19 as an occupational injury by health workers: scoping review / Notificación de COVID-19 como accidente laboral por trabajadores de la salud: scoping review

Resumo Objetivo Identificar as publicações que discorreram sobre a COVID-19 como acidente laboral e sua notificação pelos trabalhadores da saúde. Métodos A busca para esta scoping review, explorou literatura nacional e internacional, no período de 2020 e 2021, em inglês, português e espanhol, nas bases de dados do Portal Regional da Biblioteca Virtual em Saúde, na MEDLINE por meio do PubMed e no Portal de Periódicos da Capes empregou-se: Embase, Scopus, Web of Science, CINAHL. Os textos foram importados para o EndNote, suprimido os duplicados e exportados para o aplicativo Rayyan, sendo feita a inclusão dos artigos em planilha Excel com os rótulos/etiquetas: COVID-19 como acidentes de trabalho e Notificação de COVID-19. Resultados Foram identificados 5.665 estudos, excluindo 2.088 duplicações, resultando 3.577 publicações, selecionadas por título e resumo. Destas, 3.280 não atendiam aos critérios de inclusão, resultando 297 artigos. Destes, 10 foram selecionados para análise completa do texto por tratarem da COVID-19 como acidente de trabalho e/ou notificação deste agravo pelos trabalhadores da saúde. Dois artigos foram excluídos por se tratar de revisão de literatura, permanecendo 8 como corpus do estudo. Conclusão Apesar de determinados países já reconhecerem a COVID-19 como doença ocupacional, alguns trabalhadores ainda apresentam dificuldades em relacionar a infecção pelo SARS-CoV-2 com o trabalho na assistência à saúde, caracterizando como acidente laboral. Todos devem ser orientados e capacitados quanto ao reconhecimento da COVID-19 como acidente laboral e notificar sua ocorrência, uma vez que já existe a definição da infecção como doença de notificação compulsória.

Resumen Objetivo Identificar las publicaciones que abordaron el COVID-19 como accidente laboral y su notificación por parte de los trabajadores de la salud. Métodos La búsqueda para esta scoping review exploró la literatura nacional e internacional, durante el período de 2020 a 2021, en inglés, portugués y español, en las bases de datos del Portal Regional de la Biblioteca Virtual de Salud, en MEDLINE a través de PubMed, y en el Portal de Periódicos de Capes se utilizó Embase, Scopus, Web of Science, CINAHL. Los textos fueron importados a EndNote, se eliminaron los duplicados y se exportaron a la aplicación Rayyan, se incluyeron los artículos en una planilla de Excel con la clasificación/etiquetas: COVID-19 como accidente de trabajo y Notificación de COVID-19. Resultados Se identificaron 5.665 estudios, se excluyeron 2.088 duplicaciones, que dio como resultado 3.577 publicaciones, seleccionadas por título y resumen. De ellas, 3.280 no atendían los criterios de inclusión, por lo que se obtuvieron 297 artículos. De estos, 10 fueron seleccionados para análisis completo del texto porque trataban el COVID-19 como accidente de trabajo o notificación de este daño por parte de los trabajadores de la salud. Se excluyeron dos artículos porque se trataban de revisión de literatura, por lo cual permanecieron ocho como corpus de estudio. Conclusión Aunque determinados países ya reconocieron el COVID-19 como una enfermedad ocupacional, algunos trabajadores aún tienen dificultad de relacionar la infección por SARS-CoV-2 con el trabajo en la atención a la salud, caracterizándolo como un accidente laboral. Todos deben ser orientados y capacitados sobre el reconocimiento del COVID-19 como accidente laboral y notificar su ocurrencia, dado que ya existe la definición de la infección como enfermedad de notificación obligatoria.

Abstract Objective To identify the publications that discussed COVID-19 as an occupational injury and its notification by health workers. Methods The search for this scoping review explored national and international literature, between 2020 and 2021, in English, Portuguese and Spanish, in the databases of the Regional Portal of the Virtual Health Library, in MEDLINE through PubMed and in Capes Journal Portal used: Embase, Scopus, Web of Science, CINAHL. The texts were imported into EndNote, duplicates were removed and exported to the Rayyan application, and the articles were included in an Excel spreadsheet with the labels: COVID-19 as injuries at work and Notification of COVID-19. Results A total of 5665 studies were identified, excluding 2088 duplicates, resulting in 3577 publications, selected by title and abstract. Of these, 3280 did not meet the inclusion criteria, resulting in 297 articles. Of these, 10 were selected for full text analysis because they dealt with COVID-19 as an injury at work and/or notification of this condition by health workers. Two articles were excluded because they were a literature review, remaining 8 as the study's corpus. Conclusion Although certain countries already recognize COVID-19 as an occupational injury, some workers still have difficulties in relating the SARS-CoV-2 infection with work in health care, characterizing it as an occupational injured. Everyone should be guided and trained regarding the recognition of COVID-19 as an occupational injury and notify its occurrence, since the definition of the infection as a notifiable disease already exists.

Electroacupuncture and acupuncture in the treatment of anxiety - A double blinded randomized parallel clinical trial.

BACKGROUND: The estimated number of people living with anxiety disorders worldwide is around 264 million and is estimated to have worsened with the recent pandemic of COVID-19. Acupuncture has shown to have excellent therapeutic effects in reducing anxiety. DESIGN: Double-blinded randomized controlled clinical trial with 56 participants (21-82 years) with anxiety diagnosed by 3 different anxiety scales (BAI, GAD-7 and OASIS). A 30-min acupuncture session was applied once a week for 10 weeks. AIMS: Evaluate the effectiveness of acupuncture and electroacupuncture in the treatment of anxiety to verify if: (1) People with high anxiety report reduced scores after 5 and 10 sessions; (2) Salivary cortisol levels accompanied the reduced scores; (3) Electroacupuncture treatment is more effective than acupuncture; (4) the treatments is independent of anxiolytic medication. METHODS: Volunteers were randomized into 3 groups (control, acupuncture, and electroacupuncture). The results were analyzed by anxiety scales and salivary cortisol tests. RESULTS: The findings show an improvement in anxiety, assessed by BAI, GAD-7 and OASIS, after the 5th session of acupuncture (p < 0.05) and electroacupuncture (p < 0.05) and the 10th session for both techniques (p < 0.001). The salivary cortisol values measured in the morning followed this pattern (p < 0.05), although the reduction of the night cortisol values was not statistically significant. Electroacupuncture and acupuncture show similar efficacy. The positive effect after the treatments is independent of anxiolytic medication (p < 0.001). CONCLUSION: Acupuncture and electroacupuncture are effective in treating anxiety on their own or as adjuncts to pharmacological therapy. TRIAL REGISTRATION NUMBER: NºP445-08/2017 (Unidade de Investigação em Ciências da Saúde).

STOP-sexual violence: evaluation of a community-based nightlife worker awareness raising bystander training programme.

BACKGROUND: Preventing sexual violence in nightlife environments is a pervasive issue across many countries. This study explored the associated impact of a nightlife worker sexual violence awareness raising/bystander training programme (STOP-SV) on trainees' sexual violence myth acceptance and readiness and confidence to intervene. METHODS: : Pre- and post-test (n = 118), and 3-month follow-up (n = 38) trainee surveys were implemented across three countries (Czech Republic, Portugal and Spain). Paired-sample tests examined changes across time-periods in participants' myth acceptance (e.g. unwanted sexual advances are a normal part of a night out), and readiness and confidence to intervene. Multi-nominal regression was used to examine the relationship between the change in pre-to-post-training scores and trainee characteristics. RESULTS: Compared to pre-training, post-training participants were significantly (P < 0.01) less likely to agree with sexual violence myths, and more likely to be ready and confident to intervene. In bi-variate and multi-variate analyses, we found no significant associations between the change in pre-to-post-training scores and trainee characteristics. Analyses of the small follow-up sub-sample illustrated some positive changes at the post-training and follow-up time-periods (i.e. reduction in sexual violence myth acceptance). CONCLUSION: This exploratory study suggests that the STOP-SV training programme was associated with a decrease in trainees' acceptance of sexual violence myths, and an increase in their readiness and confidence to intervene. Our findings support the case for further implementation and evaluation of awareness raising/bystander programmes for nightlife workers that aim to prevent and respond to sexual violence.

Participative education with nurses: potentialities and vulnerabilities in the breast and cervical cancer tracking.

OBJECTIVES: to systematize permanent participatory education experience with Primary Care nurses on breast and cervical cancer screening, identifying potentialities and vulnerabilities. METHODS: systematic account according to Holliday, in five stages: starting point, initial questions, recovery of the lived process, background reflection and arrival points. It was the product of two workshops with 96 nurses and analyzed in the light of the ministerial guidelines and Ayres' concept of vulnerability. RESULTS: the potentialities are related to the nurse's work implementing the principles of the Unified Health System. The difficulties are complex and expose individual, contextual and programmatic vulnerabilities in the practice of screening. FINAL CONSIDERATIONS: permanent education and participatory pedagogical strategies allowed a wide and playful exchange of learning and the participation of a significant number of professionals. There is a need for studies on the institutionality of programmatic guidelines and nurses' space to be the initiator of new practices within the scope of Primary Care.

Programas de promoção de estilo de vida saudável em contexto de saúde escolar: scoping review / Programas que promueven un estilo de vida saludable en el contexto de la salud escolar: scoping review / Programs for promoting a healthy lifestyle in the context of school health: a scoping review

INTRODUÇÃO: A adoção de estilos de vida saudável (EVS) nas crianças é estimulada na escola mas a educação para a saúde orienta-se maioritariamente para as crianças, descurando a família. OBJETIVO: Mapear e examinar programas escolares de promoção de EVS nas crianças (3-10anos) que abordem 3 ou mais temáticas. MÉTODO: Scoping Review de 1992-2020 com metodologia do Institute Joanna Briggs e recurso à plataforma Rayyan QCRI. Resultados: De 4952 artigos, selecionaram-se 19 programas de promoção de EVS, de 13 países, com temas: alimentação saudável, atividade física e educação parental, mas também intervenções na dependência de ecrã, sono e higiene. DISCUSSÃO: Apesar de a maioria dos programas encontrados serem eficientes, não há consenso sobre técnicas de monitorização das dimensões dos EVS, nem intervenções holísticas de promoção de EVS. CONCLUSÃO: Programas que envolvem pais tornam-se mais eficientes. As evidências científicas encontradas podem aprimorar intervenções em saúde.

INTODUCCIÓN: En la escuela se fomenta la adopción de estilos de vida saludables (EVS) en los niños, pero la educación para la salud se orienta principalmente a los niños, descuidando a la familia. OBJETIVO: Mapear y examinar programas escolares para promover el EVS en niños (de 3 a 10 años) que aborden 3 o más temas. MÉTODO: Scoping Review de 1992-2020 siguiendo la metodología del Joanna Briggs Institute y utilizando la plataforma Rayyan QCRI. RESULTADOS: De 4952 artículos, se seleccionaron 19 programas de promoción del EVS de 13 países, con temas: alimentación saludable, actividad física y educación de los padres, pero también intervenciones sobre dependencia de la pantalla, sueño e higiene. DISCUSIÓN: Aunque la mayoría de los programas encontrados son eficientes, no hay consenso sobre técnicas para monitorear las dimensiones del EVS y sobre intervenciones holísticas para promover el EVS. CONCLUSIÓN: Los programas que involucran a los padres se vuelven más eficientes. La evidencia científica encontrada puede mejorar las intervenciones en salud.

INTRODUCTION: The adoption of healthy lifestyles (HLs) in children is encouraged at school, but health education is mainly oriented towards children, neglecting the family. OBJECTIVE: To map and examine school programs to promote HLs in children (3-10 years old) that address 3 or more topics. METHOD: A Scoping Review from 1992-2020 with the Joanna Briggs Institute methodology and using the Rayyan QCRI platform. RESULTS: Out of 4,952 articles, 19 HL promotion programs from 13 countries were selected, with the following themes: healthy eating, physical activity and parental education, but also interventions on screen dependence, sleep and hygiene.DISCUSSION: Although most of the programs found are efficient, there is no consensus on techniques for monitoring the dimensions of HLs, nor holistic interventions to promote Hls. CONCLUSION: Programs that involve parents become more efficient. The scientific evidence found can improve health interventions.

Participative education with nurses: potentialities and vulnerabilities in the breast and cervical cancer tracking / Educación participativa con enfermeros: potencialidades y vulnerabilidades en el rastreo del cáncer de mama y colon / Educação participativa com enfermeiros: potencialidades e vulnerabilidades no rastreamento do câncer de mama e colo

ABSTRACT Objectives: to systematize permanent participatory education experience with Primary Care nurses on breast and cervical cancer screening, identifying potentialities and vulnerabilities. Methods: systematic account according to Holliday, in five stages: starting point, initial questions, recovery of the lived process, background reflection and arrival points. It was the product of two workshops with 96 nurses and analyzed in the light of the ministerial guidelines and Ayres' concept of vulnerability. Results: the potentialities are related to the nurse's work implementing the principles of the Unified Health System. The difficulties are complex and expose individual, contextual and programmatic vulnerabilities in the practice of screening. Final Considerations: permanent education and participatory pedagogical strategies allowed a wide and playful exchange of learning and the participation of a significant number of professionals. There is a need for studies on the institutionality of programmatic guidelines and nurses' space to be the initiator of new practices within the scope of Primary Care.

RESUMEN Objetivos: sistematizar experiencia de educación permanente participativa con enfermeros de la Atención Primaria sobre rastreo del cáncer de mama y colon, identificando potencialidades y vulnerabilidades. Métodos: relato sistematizado conforme Holliday, en cinco tiempos: punto de partida, preguntas iniciales, recuperación del proceso vivido, reflexión de fondo y puntos de llegada. Ha sido producto de dos talleres con 96 enfermeros y analizado a la luz de las directrices ministeriales y concepto de vulnerabilidad de Ayres. Resultados: las potencialidades se relacionan al trabajo del enfermero implementando los principios del Sistema Único de Salud. Las dificultades son complejas y exponen vulnerabilidades individuales, contextuales y programáticas en la práctica del rastreo. Consideraciones finales: la educación permanente y las estrategias pedagógicas participativas permitieron cambio amplio y lúdico de aprendizajes y participación de número expresivo de profesionales. Se señala la necesidad de estudios sobre institucionalidad de las directrices programáticas y espacio del enfermero para ser instituidor de nuevas prácticas en el ámbito de la Atención Primaria.

RESUMO Objetivos: sistematizar experiência de educação permanente participativa com enfermeiros da Atenção Primária sobre rastreamento do câncer de mama e colo, identificando potencialidades e vulnerabilidades. Métodos: relato sistematizado conforme Holliday, em cinco tempos: ponto de partida, perguntas iniciais, recuperação do processo vivido, reflexão de fundo e pontos de chegada. Foi produto de duas oficinas com 96 enfermeiros e analisado à luz das diretrizes ministeriais e conceito de vulnerabilidade de Ayres. Resultados: as potencialidades relacionam-se ao trabalho do enfermeiro implementando os princípios do Sistema Único de Saúde. As dificuldades são complexas e expõem vulnerabilidades individuais, contextuais e programáticas na prática do rastreamento. Considerações Finais: a educação permanente e as estratégias pedagógicas participativas permitiram troca ampla e lúdica de aprendizagens e participação de número expressivo de profissionais. Sinaliza-se necessidade de estudos sobre institucionalidade das diretrizes programáticas e espaço do enfermeiro para ser instituidor de novas práticas no âmbito da Atenção Primária.

Rumo a uma nova geração de ensaios clínicos: pesquisa-ação participativa em saúde / Towards a new generation of clinical trials: participatory action research in health / Hacia una nueva generación de ensayos clínicos: investigación-acción participativa en salud

A Pesquisa-ação Participativa em Saúde (PaPS) é uma abordagem que inclui as pessoas no processo. Não é feita "nas" pessoas como sujeitos passivos que fornecem "dados", mas "com" elas para fornecer informações relevantes no sentido de melhorar as suas vidas e produzir soluções. O processo de pesquisa é visto como uma parceria com as pessoas cuja vida ou trabalho é o tema da pesquisa. A PaPS é uma proposta promissora para uma nova geração de ensaios clínicos, sobretudo em estudos de base comunitária pois produz evidência para fazer face a diversos desafios atuais como o uso de tecnologias emergentes de saúde e estratégias de envolvimento de pacientes/comunidade para cocriarem soluções úteis assim como a gestão dos dados e a emergência da epidemiologia participativa.

Participatory Action Research in Health (PaPS) is an approach that includes people in the process. It is not done "on" people as taxpayers who provide "data", but "with" them to provide relevant information in order to improve their lives and produce solutions. The research process is seen as a partnership with people whose life or work is the subject of the research. PaPS is a promising proposal for a new generation of clinical trials, especially in community-based studies as it produces evidence to address several current challenges such as the use of emerging health technologies and patient / community engagement strategies to co-create useful solutions as well as data management and the emergence of participatory epidemiology.

La Investigación participativa en acciones de salud (PaPS) es un enfoque que incluye a las personas en el proceso. No se hace "sobre" las personas como contribuyentes que proporcionan "datos", sino "con" ellos para proporcionar información relevante con el fin de mejorar sus vidas y producir soluciones. El proceso de investigación es visto como una asociación con personas cuya vida o trabajo es el tema de la investigación. PaPS es una propuesta prometedora para una nueva generación de ensayos clínicos, especialmente en estudios basados en la comunidad, ya que produce evidencia para abordar varios desafíos actuales, como el uso de tecnologías de salud emergentes y estrategias de participación del paciente / comunidad para cocrear soluciones útiles. así como la gestión de datos y el surgimiento de la epidemiología participativa.

Health promotion programs in higher education: integrative review of the literature.

OBJECTIVE: to characterize the interventions of health promotion programs implemented in Health Promoting Universities; to analyze the results of the interventions of health promotion programs. METHOD: integrative review carried out in EBSCO, PubMed, SciELO, Scopus and Web of Science. Articles published between 2000 and 2014 were selected, with evidence of health promotion intervention programs and evaluation of results. Results: 17 articles were included. The health promotion programs aimed at increasing the welfare of students, with an emphasis on physical activity, sexual health and on improving the environment of health support within the university community. CONCLUSION: health promotion strategies in an university context do not always result from the convergence between educational, political, legislative or organizational actions that support lifestyles and conditions which are favorable to the health of individuals or groups, and that contribute to improving the physical and social environment.

Integrative medicine in anxiety disorders.

Anxiety disorders are a current public health issue, as an estimated 16.5% of the Portuguese population suffers from this condition. The goal of this descriptive study was to analyze the efficiency of the treatment of integrative medicine (acupuncture and therapeutic massage) to reduce anxiety disorders and to describe the sociodemographic characteristics of Integrative Medicine Institute (IMI) patients. To this end, a documental analysis from the data base of the clinical reports of IMI was performed, with the approval of the Ethics Committee of the Health Sciences Research Unit with informed consents being signed by all patients. Between January and August 2017, 259 IMI patients were treated. Of these, 30,5% had been diagnosed with an anxiety disorder. Ten sessions of Integrative Medicine (IM) using acupuncture techniques combined with therapeutic massage were applied. Each session consisted of an initial treatment of acupuncture for 30 min, followed by a therapeutic massage for another 30 min. Before starting all 10 treatments, anxiety levels were measured by a self-perception 5 points scale. Anxiety levels were also assessed at the end of the 5th and the 10th treatment. It was found that 75.29% of the patients looking for IM were female and 34.4% were professionals working in intellectual and scientific activities. Patients taking anxiolytic medication presented higher levels of anxiety in comparison with non-medicated ones (p = 0.000). After a maximum of ten treatments (acupuncture combined with massage), the levels of anxiety were reduced (98.39% after five sessions). Women at their tenth treatment reached lower anxiety levels than those of men. The therapies used are proved to be efficient and can be used as a complementary care to treat and relief the symptoms of anxiety disorders. This research is the basis for designing a future randomized control trial study of acupuncture efficiency in the treatment of anxiety disorders.

Acupuncture and electroacupuncture for anxiety disorders: A systematic review of the clinical research.

Anxiety disorders are one of the most common mental health concerns with a major contribution to the global burden of disease. When not treated, anxiety can be aggravated to more serious and complicated health problems. Pharmacology and psychotherapy stand for the conventional treatment for anxiety disorders but these present limited efficacy, especially in the case of chronic anxiety, with high relapse rates and often causing adverse side effects. Clinical research studies render acupuncture as a valid treatment therapy for anxiety disorders without significant adverse effects. The objective of this paper is to review the literature on the effectiveness of acupuncture and electroacupuncture for the treatment of patients with anxiety disorders in order to find strong scientific evidence for its regular practice in Western culture. The systematic review of the clinical research was focused on published clinical trials (controlled, randomized and non-randomized) regarding the treatment of anxiety with acupuncture. Only clinical trials where anxiety was treated as the therapeutic target, and not as a secondary measurement or being associated with other health condition or disease, were considered. Two authors extracted the data independently and exclusion and inclusion criteria were set. The search rendered 1135 papers addressing anxiety as a primary therapeutic target. After review, 13 papers were identified to match exclusion and inclusion criteria and were selected for this analysis. Methodology, design, and quality of the research were highly variable and are discussed and compared. Overall, there is good scientific evidence encouraging acupuncture therapy to treat anxiety disorders as it yields effective outcomes, with fewer side effects than conventional treatment. More research in this area is however needed.

Grupos Educativos e a Saúde de Pessoas que Vivem com Doenças Crônicas Não Transmissíveis / Educational Groups and the Health of Patients Living with Chronic Noncomminucable Diseases

Objetiva-se apresentar as atividades educativas dos grupos de pessoas que vivem com DCNT e como os mesmos enfrentam a patologia. Trata-se de uma revisão integrativa, com busca nas bases de dados da BVS, PUBMED E MEDLINE, com a questão de pesquisa: quais estudos publicados em periódicos científicos da área de saúde no período de 2012 a 2016 sobre a repercussão de grupos educativos em saúde com pessoas que vivem com DCNT, visando a aplicabilidade dos achados na prática? Foram incluídas publicações disponíveis na íntegra, em português, inglês e espanhol, indexadas nas referidas bases de dados. Foram selecionados 5 artigos e analisados em duas categorias: "A educação em saúde como forma de reorientação de hábitos de vida" e "Desafios na busca da superação do modelo biomédico". A realização de grupos educativos como forma de promoção da saúde ainda necessita ser aprimorada. Compreende-se novas intervenções adequadas à realidade das pessoas com DCNT, considerando aspectos de vida e sociedade, visando sua autonomia

This study aims to explore publications on the educational activities of the groups of people living with Chronic NonCommunicable Diseases (NCDs) and how they face the pathology. It is an integrative review based on data taken from BVS, PUBMED and MEDLINE. Research question: Which studies regarding the repercussion of educational groups focused on the healthcare of people who live with NCDs were published in scientific health journals between 2012 and 2016, aiming their practical applicability? Publications that can be found online were attached to this work's database. The five selected articles were analyzed and divided in two categories: The promotion of healthcare education as a way of reorienting individuals' lifestyles and the challenges in the pursuit of overcoming the biomedical model that is popular nowadays. The organization of educational groups for the purpose of promoting healthcare still needs to be improved. It is acknowledged that new interventions, concerning the autonomy of individuals with NCDs are more appropriate to their reality

Health promotion programs in higher education: integrative review of the literature / Programas de promoción de la salud en la enseñanza superior: revisión integrativa de literatura / Programas de promoção da saúde no ensino superior: revisão integrativa de literatura

ABSTRACT Objective: to characterize the interventions of health promotion programs implemented in Health Promoting Universities; to analyze the results of the interventions of health promotion programs. Method: integrative review carried out in EBSCO, PubMed, SciELO, Scopus and Web of Science. Articles published between 2000 and 2014 were selected, with evidence of health promotion intervention programs and evaluation of results. Results: 17 articles were included. The health promotion programs aimed at increasing the welfare of students, with an emphasis on physical activity, sexual health and on improving the environment of health support within the university community. Conclusion: health promotion strategies in an university context do not always result from the convergence between educational, political, legislative or organizational actions that support lifestyles and conditions which are favorable to the health of individuals or groups, and that contribute to improving the physical and social environment.

RESUMEN Objetivo: caracterizar las intervenciones de los programas de promoción de la salud implementados en Universidades Promotoras de Salud; analizar los resultados de las intervenciones de los programas de promoción de la salud. Método: revisión integrativa realizada en la EBSCO, PubMed, SciELO, Scopus y Web of Science. Se seleccionaron artículos publicados entre los años 2000 y 2014, con evidencias de programas de intervención de promoción de la salud y evaluación de resultados. Resultados: se incluyeron 17 artículos. Los programas de promoción de la salud tenían el objetivo de aumentar el bienestar de los estudiantes, con énfasis en la actividad física, salud sexual y mejora del entorno de apoyo a la salud en el ámbito de la comunidad universitaria. Conclusión: las estrategias de promoción de la salud en el contexto universitario no siempre resultan de la convergencia entre acciones educativas, políticas, legislativas u organizacionales que apoyan estilos de vida e condiciones favorables a la salud de los individuos o colectividades y que contribuyen a la mejora del entorno físico y social.

RESUMO Objetivo: caraterizar as intervenções dos programas de promoção da saúde implementados em Universidades Promotoras de Saúde; analisar os resultados das intervenções dos programas de promoção da saúde. Método: revisão integrativa realizada na EBSCO, PubMed, SciELO, Scopus e Web of Science. Selecionaram-se artigos publicados entre os anos de 2000 e 2014, com evidências de programas de intervenção de promoção da saúde e avaliação de resultados. Resultados: foram incluídos 17 artigos. Os programas de promoção da saúde visavam aumentar o bem-estar dos estudantes, com ênfase na atividade física, saúde sexual e melhoria do ambiente de suporte à saúde no âmbito da comunidade universitária. Conclusão: as estratégias de promoção da saúde em contexto universitário nem sempre resultam da convergência entre ações educativas, políticas, legislativas ou organizacionais que apoiam estilos de vida e condições favoráveis à saúde dos indivíduos ou coletividades e que contribuem para melhoria do ambiente físico e social.

Estratégia participativa e interdisciplinar de cuidado com famílias de pessoas com fibromialgia / Participatory and interdisciplinary care strategy to families of people with fibromyalgia / Estrategia participativa e interdisciplinaria del cuidado con famílias de personas con fibromialgia

Objetivos: identificar o entendimento das famílias sobre fibromialgia, descrever as mudanças na rotina e analisar as estratégias de cuidado desenvolvidas pelas redes familiares. Método: pesquisa qualitativa, participativa, fundamentada na teoria freireana, com oito participantes de uma instituição universitária do Rio de Janeiro. Produção de dados em 2016, abrangendo o Mapa Falante e World Café. Dados submetidos à análise de conteúdo. Projeto aprovado por Comitê de Ética em Pesquisa nº 1.587.664. Resultados: dessa análise emergiram três categorias temáticas: Necessidades de mudanças; Organização da família; e Estratégias de cuidado. Conclusão: a família entende que a dor é um fator limitante e desencadeador da doença. As mudanças referidas foram a desorganização do cotidiano familiar e do convívio social, gerando desconforto físico e psíquico. A união, presença e atenção foram as estratégias de cuidado. Torna-se importante a mediação interdisciplinar com práticas participativas, reflexivas e sensíveis.

Objectives: to identify families' understanding about fibromyalgia, to describe changes in the family routine and to analyze strategies of care developed by family networks. Method: qualitative and participative research, based on Paulo Freire's theory, with eight participants from an university institution of Rio de Janeiro. Data were coleected in 2016, using Talking-Maps and World Café. Data were submetted to content analysis. The study was approved by Research Ethics Committee (Protocol nº 1.587.664). Results: three categories emerged: Need for changes; Family organization; and Strategies of care. Conclusion: family understands that pain is a limiting factor and a triggering of the disease. Changes referred were related to family daily life and social interaction disorganization, leading to physical and psychological discomfort. Unity, presence and attention were described as strategies of care. Interdisciplinary mediation with participatory, reflexive and sensitive practices becomes important.

Objetivo: identificar la comprensión de las familias sobre la fibromialgia, describir los cambios en la rutina familiar y analizar las estrategias de atención desarrolladas por las redes familiares. Método: investigación cualitativa y participativa, basada en la teoría de Paulo Freire, con ocho participantes de una institución universitaria de Río de Janeiro. Los datos fueron compilados en 2016, utilizando Mapa Altavolz y World Café. Los datos fueron submetidos al análisis de contenido. El estudio fue aprobado por el Comité de Ética en Investigación (Protocolo nº 1.587.664). Resultados: surgieron tres categorías: necesidad de cambios; Organización familiar; y Estrategias de cuidado. Conclusión: la familia entiende que el dolor es un factor limitante y desencadenante de la enfermedad. Los cambios referidos se relacionaron con la vida familiar cotidiana y la desorganización de la interacción social, lo que generó malestar físico y psicológico. La unidad, la presencia y la atención se describieron como estrategias de cuidado. La mediación interdisciplinaria con prácticas participativas, reflexivas y sensibles se vuelve importante.

Interdisciplinary care praxis in groups of people living with fibromyalgia. / Práxis interdisciplinar de cuidado em grupo de pessoas que vivem com fibromialgia.

OBJECTIVES:: to analyze the integrated community therapy model for the empowerment of people living with fibromyalgia and discuss the impact of this interdisciplinary intervention in the health-disease process and self-care. METHOD:: a participatory-approach qualitative study, developed in 2015 with 11 participants at the Laboratory of Physiology Applied to Physical Education of the Rio de Janeiro State University, RJ. Data production comprised World Café, participant observation and semi-structured interview. The analysis was performed according to Bardin, through data triangulation in dialogue with the relevant literature. RESULTS:: the integrated community therapy group is a driving force in building and expanding knowledge about fibromyalgia and in self-care empowerment. CONCLUSION:: this group strategy proved to be an interdisciplinary praxis tool that enables the development of solidary care networks. Thus, shared knowledge was generated, transformed into a listening and reflection environment to manage personal and family obstacles.

Práxis interdisciplinar de cuidado em grupo de pessoas que vivem com fibromialgia / Praxis interdisciplinaria del cuidado en grupo de personas que viven con fibromialgia / Interdisciplinary care praxis in groups of people living with fibromyalgia

RESUMO Objetivos: analisar o modelo da terapia comunitária integrativa para o empoderamento de pessoas que vivem com fibromialgia e discutir a repercussão dessa intervenção interdisciplinar no processo saúde-doença e autocuidado. Método: estudo qualitativo de abordagem participativa, desenvolvido em 2015 com 11 participantes, no Laboratório de Fisiologia aplicada à Educação Física da Universidade do Estado do Rio de Janeiro, RJ. A produção de dados abrangeu o World Café, a observação participante e entrevista semiestruturada. A análise foi realizada segundo Bardin, pela triangulação de dados em diálogo com a literatura pertinente. Resultados: o grupo de terapia comunitária integrativa é um dinamizador na construção e ampliação do conhecimento sobre a fibromialgia e no empoderamento para o autocuidado. Conclusão: esta estratégia de grupo revelou-se um instrumento de práxis interdisciplinar que permite construir redes solidárias de cuidado. Desse modo, gerou-se o conhecimento compartilhado, transformado em ambiente de escuta e reflexão para gerir os obstáculos pessoais e familiares.

RESUMEN Objetivos: analizar el modelo de terapia comunitaria integradora para el empoderamiento de las personas que viven con fibromialgia y discutir el impacto de esta intervención interdisciplinaria en el proceso de salud-enfermedad y autocuidado. Método: estudio cualitativo de enfoque participativo, desarrollado en 2015 con 11 participantes en el Laboratorio de Fisiología aplicada a la Educación Física de la Universidade do Estado do Rio de Janeiro, RJ. La producción de datos incluyó el World Café, la observación participante y la entrevista semi-estructurada. El análisis se realizó de acuerdo con Bardin por la triangulación de los datos en diálogo con la literatura relevante. Resultados: el grupo de terapia comunitaria integradora es una fuerza impulsora en la construcción y ampliación de conocimientos sobre la fibromialgia y el empoderamiento para el autocuidado. Conclusión: esta estrategia de grupo ha demostrado ser una herramienta de praxis interdisciplinaria que permite la construcción de redes de solidaridad de la atención. Así, se ha generado conocimiento compartido, transformado en un ambiente de escucha y reflexión para manejar los obstáculos personales y familiares.

ABSTRACT Objectives: to analyze the integrated community therapy model for the empowerment of people living with fibromyalgia and discuss the impact of this interdisciplinary intervention in the health-disease process and self-care. Method: a participatory-approach qualitative study, developed in 2015 with 11 participants at the Laboratory of Physiology Applied to Physical Education of the Rio de Janeiro State University, RJ. Data production comprised World Café, participant observation and semi-structured interview. The analysis was performed according to Bardin, through data triangulation in dialogue with the relevant literature. Results: the integrated community therapy group is a driving force in building and expanding knowledge about fibromyalgia and in self-care empowerment. Conclusion: this group strategy proved to be an interdisciplinary praxis tool that enables the development of solidary care networks. Thus, shared knowledge was generated, transformed into a listening and reflection environment to manage personal and family obstacles.

[Translation, adaptation and validation of the Fantastic Lifestyle Assessment questionnaire with students in higher education]. / Tradução, adaptação e validação do questionário Fantastic Lifestyle Assessment em estudantes do ensino superior.

The scope of this study was to make the translation, cultural adaptation and validation of the Fantastic Lifestyle Assessment questionnaire in a group of students in higher education in Portugal. The process of translation and validation consisted of translation, back translation, expert committee review, pre-testing and testing of the psychometric properties. The final version adapted with 30 questions was applied to a sample of 707 university students. The results showed that the instrument demonstrated good overall internal consistency for an instrument used to measure a latent variable. When the items were grouped into domains, it was found that they all contributed equally to the stability of the instrument. The reproducibility assessed by intraclass correlation was high. Construct validity tested by the classification capacity of the instrument in four, three and two categories was 67.6%, 67.6% and 100%, with a Kappa index of 0.55, 0.55 and 1.00, respectively. The concurrent validity was also evaluated by correlating it with "My Lifestyle," namely another instrument measuring the same construct. The conclusion was that the Fantastic Lifestyle Assessment, is a reliable and valid instrument for lifestyle assessment in young adults.

Tradução, adaptação e validação do questionário Fantastic Lifestyle Assessment em estudantes do ensino superior / Translation, adaptation and validation of the Fantastic Lifestyle Assessment questionnaire with students in higher education

O presente estudo teve como objectivo realizar a tradução, adaptação transcultural e validação do questionário Fantastic Lifestyle Assessment num grupo de jovens estudantes do ensino superior em Portugal. O processo de tradução e validação constituiu-se de: tradução, retrotradução, revisão por comitê de especialistas, pré-teste e verificação das propriedades psicométricas. A versão final adaptada com 30 questões foi aplicada a uma amostra de 707 estudantes do ensino superior. Os resultados mostraram que o instrumento apresentou boa consistência interna global para um instrumento que é usado para medir uma variável latente. Quando agrupados os itens em domínios, verificou-se que todos contribuem de maneira semelhante para a estabilidade do instrumento. A reprodutibilidade, avaliada pela correlação intraclasse, foi alta. A validade de construto testada pela capacidade classificatória do instrumento em quatro, três e duas categorias foi de 67,6%, 67,6% e 100%, com um índice de Kappa de 0.55, 0.55 e 1.00, respetivamente. Foi ainda avaliada a validade concorrente através da correlação com Inventário "O Meu Estilo de Vida", outro instrumento que mede o mesmo construto. Conclui-se que este Fantastic Lifestyle Assessment é fiável e válido, para a avaliação do estilo de vida em jovens adultos.

The scope of this study was to make the translation, cultural adaptation and validation of the Fantastic Lifestyle Assessment questionnaire in a group of students in higher education in Portugal. The process of translation and validation consisted of translation, back translation, expert committee review, pre-testing and testing of the psychometric properties. The final version adapted with 30 questions was applied to a sample of 707 university students. The results showed that the instrument demonstrated good overall internal consistency for an instrument used to measure a latent variable. When the items were grouped into domains, it was found that they all contributed equally to the stability of the instrument. The reproducibility assessed by intraclass correlation was high. Construct validity tested by the classification capacity of the instrument in four, three and two categories was 67.6%, 67.6% and 100%, with a Kappa index of 0.55, 0.55 and 1.00, respectively. The concurrent validity was also evaluated by correlating it with "My Lifestyle," namely another instrument measuring the same construct. The conclusion was that the Fantastic Lifestyle Assessment, is a reliable and valid instrument for lifestyle assessment in young adults.