Alcohol Use Disorder and Chronic Pain: An Overlooked Epidemic.

Alcohol use disorder (AUD) and chronic pain disorders are pervasive, multifaceted medical conditions that often co-occur. However, their comorbidity is often overlooked, despite its prevalence and clinical relevance. Individuals with AUD are more likely to experience chronic pain than the general population. Conversely, individuals with chronic pain commonly alleviate their pain with alcohol, which may escalate into AUD. This narrative review discusses the intricate relationship between AUD and chronic pain. Based on the literature available, the authors present a theoretical model explaining the reciprocal relationship between AUD and chronic pain across alcohol intoxication and withdrawal. They propose that the use of alcohol for analgesia rapidly gives way to acute tolerance, triggering the need for higher levels of alcohol consumption. Attempts at abstinence lead to alcohol withdrawal syndrome and hyperalgesia, increasing the risk of relapse. Chronic neurobiological changes lead to preoccupation with pain and cravings for alcohol, further entrenching both conditions. To stimulate research in this area, the authors review methodologies to improve the assessment of pain in AUD studies, including self-report and psychophysical methods. Further, they discuss pharmacotherapies and psychotherapies that may target both conditions, potentially improving both AUD and chronic pain outcomes simultaneously. Finally, the authors emphasize the need to manage both conditions concurrently, and encourage both the scientific community and clinicians to ensure that these intertwined conditions are not overlooked given their clinical significance.

Health care itineraries for women in situations of abortion: methodological aspects of a qualitative study for Birth in Brazil II survey. / Itinerários de cuidado à saúde de mulheres em situações de abortamento: aspectos metodológicos do estudo qualitativo da pesquisa Nascer no Brasil II.

In recent decades, several academic studies on abortion have been produced in Brazil, with different designs, objectives, and methodologies. However, due to the diversity of situations in which Brazilian women experience abortion, the complexity of this topic, and its modulations in different political and sociocultural contexts, it still challenges academicians and the fields of health and reproductive rights. In this article, we present methodological aspects of a qualitative study on health care itineraries of women in situations of abortion, a component of the Birth in Brazil II survey, whose objective is to discuss the effects of gender; race/ethnicity; social class; generational, regional, and territorial inequalities on care itineraries. We discuss the study design development, the construction of the theoretical framework and specific analytical axes, the development of interview instrument, definition of participant selection criteria, strategies to contact participants and conduct the interviews, management of field work and materials produced, analytical procedures, and ethical issues. In total, 120 narrative interviews were conducted in order to include a diversity of women and obtain detailed results from the quantitative analysis under Birth in Brazil II survey. The context of criminalization of abortion has an impact on the production of knowledge on this subject, creating challenges such as difficult access to women, women's anonymity, privacy and data confidentiality, creation of objective and subjective conditions so that they can narrate their experiences in depth. With this article, we seek to contribute to the debate about these challenges in abortion research in Brazil.

Nas últimas décadas, produziu-se um robusto corpus de pesquisas sobre aborto no Brasil, com diferentes desenhos, objetos e metodologias. Contudo, pela diversidade de situações em que as mulheres brasileiras vivenciam o abortamento, pela complexidade do tema e por suas modulações em contextos políticos e socioculturais distintos, o assunto não cessa de desafiar a academia, o campo da saúde e dos direitos reprodutivos. Neste artigo, apresentamos aspectos metodológicos de um estudo qualitativo sobre itinerários de cuidado à saúde de mulheres em situações de abortamento, componente da pesquisa Nascer no Brasil II, que objetiva discutir efeitos das desigualdades de gênero, de raça/etnia, de classe social, geracionais, regionais e territoriais nesses percursos. Discutimos o desenvolvimento do desenho do estudo; a construção do arcabouço teórico e recortes analíticos específicos; a elaboração do instrumento de entrevista; os critérios de seleção das mulheres; as estratégias de abordagem e condução das entrevistas; a gestão do fluxo do campo e dos materiais produzidos; os procedimentos analíticos; e os problemas éticos. Para incluir uma diversidade de mulheres e aprofundar resultados do componente quantitativo do Nascer no Brasil II, serão realizadas 120 entrevistas narrativas. O contexto de criminalização do aborto impacta a produção de conhecimento sobre o tema, impondo desafios como conseguir acesso às mulheres, assegurar o anonimato e sua privacidade, além do sigilo das informações, gerar condições objetivas e subjetivas para que possam narrar em profundidade as suas experiências. Com este artigo, procuramos contribuir para o debate sobre esses desafios das pesquisas sobre aborto no Brasil.

En las últimas décadas, se produjo un robusto corpus de investigaciones sobre el aborto en Brasil, con diferentes diseños, objetos y metodologías. Sin embargo, debido a la diversidad de situaciones en las que las mujeres brasileñas vivencian el abortamiento, la complejidad del tema y sus modulaciones en diferentes contextos políticos y socioculturales, el tema continúa desafiando a la academia, el campo de la salud y los derechos reproductivos. En este artículo, presentamos aspectos metodológicos de un estudio cualitativo sobre los itinerarios de cuidados de la salud de mujeres en situación de abortamiento, componente de la encuesta Nacer en Brasil II, que tiene como objetivo discutir los efectos de las desigualdades de género, raza/etnia, clase social, generacionales, regionales y territoriales en esos recorridos. Discutimos el desarrollo del diseño del estudio, la construcción del marco teórico y los recortes analíticos específicos, la elaboración del instrumento de entrevista, los criterios de selección de las mujeres, las estrategias de abordaje y realización de las entrevistas, el manejo del flujo del campo y de los materiales producidos, los procedimientos analíticos y los problemas éticos. Para abarcar una diversidad de mujeres y profundizar los resultados del componente cuantitativo de Nacer en Brasil II, se realizarán 120 entrevistas narrativas. El contexto de criminalización del aborto impacta la producción de conocimiento sobre el tema, imponiendo desafíos, tales como conseguir acceso a las mujeres, asegurar su anonimato y privacidad y la confidencialidad de la información, generar condiciones objetivas y subjetivas para que puedan narrar en profundidad sus experiencias. Con este artículo buscamos contribuir al debate sobre estos desafíos de las investigaciones sobre el aborto en Brasil.

Incorporation, adaptation and rejection of obstetric practices during the implementation of the "Adequate Childbirth Program" in Brazilian private hospitals: a qualitative study.

BACKGROUND: The "Adequate Childbirth Program" (PPA) is a quality improvement project that aims to reduce the high rates of unnecessary cesarean section in Brazilian private hospitals. This study aimed to analyze labor and childbirth care practices after the first phase of PPA implementation. METHOD: This study uses a qualitative approach. Eight hospitals were selected. At each hospital, during the period of 5 (five) days, from July to October 2017, the research team conducted face to face interviews with doctors (n = 21) and nurses (n = 28), using semi-structured scripts. For the selection of professionals, the Snowball technique was used. The interviews were transcribed, and the data submitted to Thematic Content Analysis, using the MaxQda software. RESULTS: The three analytical dimensions of the process of change in the care model: (1) Incorporation of care practices: understood as the practices that have been included since PPA implementation; (2) Adaptation of care practices: understood as practices carried out prior to PPA implementation, but which underwent modifications with the implementation of the project; (3) Rejection of care practices: understood as those practices that were abandoned or questioned whether or not they should be carried out by hospital professionals. CONCLUSIONS: After the PPA, changes were made in hospitals and in the way, women were treated. Birth planning, prenatal hospital visits led by experts (for expecting mothers and their families), diet during labor, pharmacological analgesia for vaginal delivery, skin-to-skin contact, and breastfeeding in the first hour of life are all included. To better monitor labor and vaginal birth and to reduce CS without a clinical justification, hospitals adjusted their present practices. Finally, the professionals rejected the Kristeller maneuver since research has demonstrated that using it's harmful.

Brazil has high Cesarean Section (CS) rates, with rates far from the ideal recommended by the World Health Organization and a model of care that does not favor women's autonomy and empowerment. In 2015, a quality improvement project, called "Projeto Parto Adequado" (PPA), was implemented in Brazilian private hospitals to reduce unnecessary cesarean section, in addition to encouraging the process of natural and safe childbirth. One of the components of this project was to reorganize the model of care in hospitals to prepare professionals for humanized and safe care. The data were collected in 8 hospitals with interviews with 49 professionals, approximately two years after the beginning of the project in the hospitals. There were changes in the hospital routine and in the care of women after the project. The professionals incorporated practices such as skin-to-skin contact and breastfeeding; diet during labor; non-invasive care technologies, especially to relieve pain during labor; birth plan; pregnancy courses with guided tours in hospitals (for pregnant women and family); and analgesia for vaginal labor. There was adaptation of existing practices in hospitals to reduce CS that had no clinical indication; better monitoring of labor, favoring vaginal delivery. And finally, the professionals rejected the practice that presses the uterine fundus, for not having shown efficacy in recent studies. We can conclude that the hospitals that participated in this study have made an effort to change their obstetric model. However, specific aspects of each hospital, the organization of the health system in Brazil, and the incentive of the local administration influenced the implementation of these changes by professionals in practice.

Application of Goat and Lamb Lipases on the Development of New Immobilized Biocatalysts Aiming at Fish Oil Hydrolysis.

The use of lipases from animal sources for the synthesis of new biocatalysts is barely studied in the literature. The present work focused on the immobilization of lipases from kid goat's and lamb's epiglottis in different ionic supports. For this, anionic supports (monoaminoethyl-N-aminoethyl-agarose (MANAE) and diethylaminoethyl-agarose (DEAE)) and cationic supports (carboxymethyl-agarose and sulfopropyl-agarose) were used. The immobilization parameters were evaluated, as well as the thermal stability of the immobilized enzymes and their stability at different values of pH. Then, the performance of the biocatalysts was evaluated in hydrolysis reactions for obtaining omega-3 fatty acids from fish oil (eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA)). Values of 100% of recovered activity were obtained for lipase from goats, indicating that it was possible to maintain all the enzymatic activities of the immobilized enzymes on the supports. The immobilized enzymes were more stable in different pH conditions and at a temperature of 50 °C, reaching values of stabilization factor of 12.17 and t1/2 of 9.86 h-1, for lamb lipase immobilized in sulfopropyl agarose. In general, the anionic supports led to lower Km values and the cationic ones to a higher Vmax. Lamb lipase showed the highest selectivity values for EPA/DHA, reaching values of 6.43 using MANAE. Thus, the high potential for using such biocatalysts from animal sources in the food or pharmaceutical industries is observed.

Effects of Mannosylerythritol-Lipids-B on Cutibacterium acnes ATCC 6919.

Mannosylerythritol-lipids-B (MEL-B) are microbial-produced glycolipids with skincare properties, notably moisturizing, antimelanogenic, antimicrobial, and antiaging. Thus, there is a potential use of MEL-B in a formulation for treating acne-prone skin. This study investigated the antimicrobial effect of MEL-B against the Gram-positive bacteria Cutibacterium acnes. The broth macro dilution method was used to evaluate the growth of C. acnes (3-4 CFU/mL), in the absence (positive control) or presence of MEL-B (128, 192, 256, and 512 µg/mL). Additionally, the leakage of genetic materials was used to determine the potential drug-induced membrane disruption of glycolipids. The amount of DNA and RNA release was quantified spectrophotometrically at 260 nm. Macro dilution technique and membrane integrity experiments showed that MEL-B does not have antimicrobial activity against C. acnes. Indeed, MEL-B assisted C. acnes growth. Ultimately, MEL-B has been reported as a remarkably active compound for skincare formulations; however, preliminarily, it should be avoided for acneic skin.

Envenomation by a common green racer (Chlorosoma viridissimum) in the Brazilian Amazon: A report of three cases.

Envenomations by the common green racer (Chlorosoma viridissimum) are seldom reported in the literature. Herein, we report three cases caused by the same specimen of C. viridissimum in three different victims in the Brazilian Amazon. In all cases, the victims were either a biologist or biology students that were handling the animal and were bitten in their upper limbs. The victims showed only local symptoms, such as edema, tooth marks, pain, erythema, ecchymoses and bleeding. One of the patients presented extensive ecchymosis. Two patients sought medical care, but were only treated for local manifestations and evolved without complications. Chlorosoma viridissimum is capable of provoking mild to moderate signs and symptoms.

The Potential of Crude and Partially Purified Black Rice Bran Extracts Obtained by Ultrasound-Assisted Extraction: Anti-Glycemic, Cytotoxicity, Cytoprotective, and Antitumoral Effects.

Recovering anthocyanins from black rice bran is a way of valuing this byproduct, by obtaining an extract with biological potential. The objective of this study was to recover anthocyanins using ultrasound-assisted extraction. Some of the extract was partially purified, and both (crude and partially purified) extracts were evaluated for their anthocyanin content, antioxidant activity, antidiabetic and antitumoral activities, cytotoxicity, and oxidative stress. An increase in the laboratory scale was also achieved, making possible to increase the extraction volume up to 20 times without significantly changing the content of anthocyanins (1.85 mg C3G/g DW). It was found that the purified sample presented a 4.2 times higher value of total anthocyanins compared to the crude sample. The best IC50 values for the purified sample were verified by DPPH and ABTS (0.76 and 0.33 mg/mL). The best results for antidiabetic activity were obtained for the partially purified sample: 0.82 µM C3G for α-glucosidase and 12.5 µM C3G for α-amylase. The extracts demonstrated protection (~70%) when subjected to the oxidative stress of L929 cells. An antitumoral effect of 25-30% for both extracts was found in A459 cells. The crude and partially purified extracts of black rice have antidiabetic and anticancer effects and more studies are needed to explore their potential.

Functional characterization and structural insights of three cutinases from the ascomycete Fusarium verticillioides.

Cutinases are serine esterases that belong to the α/ß hydrolases superfamily. The natural substrates for these enzymes are cutin and suberin, components of the plant cuticle, the first barrier in the defense system against pathogen invasion. It is well-reported that plant pathogens produce cutinases to facilitate infection. Fusarium verticillioides, one important corn pathogens, is an ascomycete upon which its cutinases are poorly explored. Consequently, the objective of this study was to perform the biochemical characterization of three precursor cutinases (FvCut1, FvCut2, and FvCut3) from F. verticillioides and to obtain structural insights about them. The cutinases were produced in Escherichia coli and purified. FvCut1, FvCut2, and FvCut3 presented optimal temperatures of 20, 40, and 35 °C, and optimal pH of 9, 7, and 8, respectively. Some chemicals stimulated the enzymatic activity. The kinetic parameters revealed that FvCut1 has higher catalytic efficiency (Kcat/Km) in the p-nitrophenyl-butyrate (p-NPB) substrate. Nevertheless, the enzymes were not able to hydrolyze polyethylene terephthalate (PET). Furthermore, the three-dimensional models of these enzymes showed structural differences among them, mainly FvCut1, which presented a narrower opening cleft to access the catalytic site. Therefore, our study contributes to exploring the diversity of fungal cutinases and their potential biotechnological applications.

Infertilidade, justiça reprodutiva e pandemia de COVID-19: reflexões sobre acesso e barreiras / Infertility, reproductive justice and the COVID-19 pandemic: reflections on access and barriers / Infertilidad, justicia reproductiva y la pandemia de COVID-19: reflexiones sobre acceso y barreras

Objetivo: refletir sobre o acesso a serviços de saúde para infertilidade e reprodução humana assistida durante o período da pandemia de COVID-19, na perspectiva da justiça reprodutiva. Metodologia: utilizou-se dados do inquérito online da pesquisa Pandemia de COVID-19e práticas reprodutivas de mulheres no Brasil, que obteve 8.313 respostas de mulheres residentes em todas as regiões do país, de 18 anos ou mais. O questionário autoaplicável circulou entre julho e outubro de 2021, contendo questões fechadas e abertas. A análise descritiva das respostas objetivas de 242 mulheres que referiram buscar atendimento para infertilidade contou com o cálculo de frequências simples das variáveis. Já os textos escritos nos espaços abertos do questionário foram submetidos à análise temática. Resultados: o estudo verificou a existência de barreiras institucionais e não institucionais para os cuidados da infertilidade, ambas incrementadas pela pandemia. Conclusão: recomenda-se a efetivação de política pública que garanta acesso pleno a todas as pessoas, haja vista que o tratamento para infertilidade e reprodução assistida tende a se restringir a mulheres cisgênero, de camadas médias e altas, mais escolarizadas e majoritariamente brancas.

Objective: to critically examine access to health services for infertility and assisted human reproduction during the COVID-19 pandemic, emphasizing the perspective of reproductive justice. Methods: data for analysis were derived from the online survey titled COVID-19 Pandemic and Women's Reproductive Practices in Brazil, garnering 8,313 responses from women aged 18 years or older residing in all regions of the country. The self-administered questionnaire circulated from July to October 2021 and comprised both closed and open-ended questions. Descriptive analysis of the objective responses obtained from 242 women actively seeking infertility care involved the calculation of simple frequencies for relevant variables. Responses provided in the open-ended sections of the questionnaire underwent thematic analysis. Results: revealed the presence of both institutional and non-institutional barriers to infertility care, with a notable exacerbation during the pandemic. Conclusion: given that infertility and assisted reproduction treatment predominantly cater to cisgender women from middle and upper socio-economic strata, characterized by higher education levels and mostly white, there is a compelling need for the implementation of public policies that ensure equitable access for all individuals.

Objetivo: reflexionar sobre el acceso a los servicios de salud para la infertilidad y la reproducción humana asistida durante el período de la pandemia de COVID-19, desde la perspectiva de la justicia reproductiva. Metodología: se utilizaron datos de la encuesta en línea de la Pandemia de COVID-19y prácticas reproductivas de las mujeres en Brasil, que obtuvo 8.313 respuestas de mujeres residentes en todas las regiones del país, con edad igual o superior a 18 años. El cuestionario autoaplicado circuló entre julio y octubre de 2021, conteniendo preguntas cerradas y abiertas. El análisis descriptivo de las respuestas objetivas de 242 mujeres que relataron buscar atención por infertilidad implicó el cálculo de frecuencias simples de las variables. Los textos escritos en los espacios abiertos del cuestionario fueron sometidos a análisis temático. Resultados:el estudio verificó la existencia de barreras institucionales y no institucionales para la atención de la infertilidad, ambas aumentadas por la pandemia. Conclusión: se recomiendala implementación de una política pública que garantice el pleno acceso a todas las personas, dado que el tratamiento de la infertilidad y reproducción asistida tiende a estar restringido a mujeres cisgénero de clase media y alta, con mayor educación y en su mayoría blancas.

Saúde, reprodução e sexualidade nos tempos da COVID-19: memórias incorporadas das mulheres no Brasil / Health, reproduction and sexuality in times of COVID-19: embodied memories of women in Brazil / Salud, reproducción y sexualidad en los tiempos de COVID-19: memorias encarnadas de las mujeres en Brasil

Objetivo: compreender como a pandemia de COVID-19 afetou a vida e a saúde das mulheres, com ênfase nos aspectos da saúde sexual e reprodutiva, e refletir sobre os direitos sexuais e reprodutivos e a justiça reprodutiva no contexto da crise sanitária. Metodologia: utilizou-se questionário online com 113 perguntas objetivas e uma questão aberta para comentários. De 8.313 mulheres que responderam ao questionário, 1.838 relataram suas vivências durante a pandemia na questão aberta. Esse material passou por técnicas de análise narrativa e temática e de construção de memória. Resultados: evidenciou-se a ampliação das dificuldades de acesso a serviços de saúde, em especial de saúde sexual e reprodutiva; o aprofundamento das iniquidades na divisão sexual do trabalho, com sobrecarga de trabalho doméstico e profissional; a insegurança econômica; o tensionamentos das relações afetivo-sexuais e maior exposição à violência; e importantes repercussões na saúde psicoemocional. Todos esses aspectos afetaram as experiências de saúde e adoecimento; a vida sexual; e os planos e experiências reprodutivas nos primeiros anos de pandemia. Conclusão: no Brasil, na sobreposição da emergência sanitária com a crise democrática de direitos, fatos sociais e fatos fisiológicos se misturam e se totalizam na experiência histórica e material do corpo sexual e reprodutivo das mulheres, seguindo as linhas de força das precariedades e injustiças de gênero, de raça e de classe. Os relatos das mulheres contribuem para a construção de uma memória coletiva ­não necessariamente unívoca e linear ­da pandemia. Memórias que podem não apenas ilustrar o momento presente, como contribuir para o entendimento e enfrentamento de crises semelhantes futuras.

Objective: this study seeks to comprehend the impact of the COVID-19 pandemic on women's lives and health, with a particular focus on sexual and reproductive health, andto reflect on sexual and reproductive rights and reproductive justice within the context of the health crisis.Methods:employing an online questionnaire featuring 113 objective questions and one open-ended question for free comments, the study gathered responses from 8,313 women. Out of these, 1,838 utilized the open question to articulate their experiences during the pandemic. The collected material underwent analysis using narrative and thematic approaches, along with memory construction techniques.Results:the findings indicate heightened challenges in accessing health services, particularly for sexual and reproductive health. The pandemic deepened inequities in the sexual division of labor, leading to increased domestic and professional workloads, economic insecurity, elevated tensions in affective-sexual relationships, greater exposure to violence, and notable repercussions on psycho-emotional health. These factors collectively influenced women's health/illness experiences, sexual lives, and reproductive plans during the initial years of the pandemic. Conclusion: the intersection of the health crisis with a democratic crisis in rights has intertwined social and physiological factors into the historical and material experiences of women's sexual and reproductive bodies. These experiences follow the trajectories of gender, race, and class-based precariousness and injustices. Women's accounts contribute to the construction of a collective memory of the pandemic that is not necessarily uniform or linear. Beyond illustrating the present moment, these memories aid in understanding and addressing similar crises in the future.

Objetivo: comprender cómo la pandemia de COVID-19 afectó la vida y la salud de las mujeres, con énfasis en aspectos de salud sexual y reproductiva y reflexionar sobre los derechos sexuales y reproductivos y la justicia reproductiva, en el contexto de la crisis sanitaria. Metodología:se utilizó un cuestionario online con 113 preguntas objetivas y una pregunta abierta para comentarios libres al final. De 8.313 mujeres que respondieron el cuestionario, 1.838 relataron sus experiencias durante la pandemia, en este espacio abierto. Este material fue analizado mediante técnicas análisis de narrativa y temática y de construcción de memoria. Resultados: hubo aumento de las dificultades para acceder a los servicios de salud, especialmente de salud sexual y reproductiva, profundización de las inequidades en la división sexual del trabajo, con sobrecarga de trabajo doméstico y profesional, inseguridad económica, tensiones en las relaciones afectivo-sexuales y mayor exposición. a la violencia, e importantes repercusiones en la salud psicoemocional. Todos estos aspectos afectaron las experiencias de salud/enfermedad, la vida sexual, los planes y experiencias reproductivas, en los primeros años de la pandemia. Conclusión: en Brasil, en el solapamiento de la crisis sanitaria con la crisis democrática y de derechos, hechos sociales y hechos fisiológicos se mezclan y totalizan en la experiencia histórica y material de los cuerpos sexuales y reproductivos de las mujeres, siguiendo las líneas de fuerza de la precariedad y las injusticias. de género, raza y clase. Las narrativas de las mujeres contribuyen a la construcción de una memoria colectiva ­no necesariamente unívoca y lineal ­ de la pandemia. Memorias que no sólo pueden ilustrar el momento presente, sino que también contribuyen a comprender y afrontar crisis futuras similares.

Association between hearing loss and cognitive decline in the elderly: A systematic review with meta-analysis study.

OBJECTIVE: Hearing loss has been pointed out as a potential predictor for cognitive decline. This study conducted a systematic review to evaluate the scientific evidence on the association between hearing loss in the elderly and cognitive decline, as well as whether race/color influences this relationship. METHOD: The search for studies was performed in the following electronic databases: MedLine/PubMed Web of Science, Scopus and Virtual Health Library, and MedRkiv up to August 2022. Studies with epidemiological designs that assess the association between hearing loss and cognitive decline in the elderly were eligible for inclusion. Three independent reviewers performed the selection, data extraction and evaluation of the quality of the studies using the Newcastle-Ottawa Scale. A meta-analysis using a random effects model estimated the global association measurements (Beta coefficient: ß) and their 95% confidence intervals (95%CI), and the Higgins and Thompson indicator (I2) was also estimated to assess statistical heterogeneity among the studies. RESULTS: 5,207 records were identified in the database surveys, of which only 18 were eligible studies, totaling 19,551 individuals. Hearing loss was associated with cognitive decline in the elderly, with statistical significance: ß = -0.13; 95%CI = -0.23 to -0.04; I2 = 98.70%). For black individuals, the magnitude of the association increased: ß = -0.64; 95%CI = -3.36 to 2.07; I2 = 95.65%, but it was not statistically significant. CONCLUSION: The findings of this systematic review showed the existence of a significant relationship between hearing loss and cognitive decline in the elderly, as well as signaling that among black individuals the magnitude of the association can be increased.

"Louco sim, drogado não": o imaginário de profissionais da saúde mental / "Crazies over junkies": The collective imagination of mental health professionals

Considerando que as práticas clínicas se baseiam tanto em conhecimentos científicos como em crenças e valores nem sempre conscientes, este estudo objetiva investigar o imaginário coletivo de profissionais de saúde mental sobre o paciente psiquiátrico, na perspectiva da psicologia psicanalítica concreta. Justifica-se, portanto, desde o interesse em aperfeiçoar a qualidade do atendimento, tendo em vista tanto o benefício dos pacientes, como a melhoria das condições de exercício profissional. A partir de uma entrevista psicológica coletiva, articulada ao redor do uso do Procedimento de Desenhos-Estórias com Tema, abordamos sete profissionais de nível superior que trabalham em equipamento de saúde mental. A consideração do material permitiu a produção interpretativa de dois campos de sentido afetivo-emocional: "Sofredores psicóticos" e "Impostores dependentes". O quadro geral apresenta a coexistência de visões solidárias e éticas diante do psicótico com visões preconceituosas e hostis em relação ao dependente químico. Esse contraste se baseia sobretudo na dificuldade em perceber que a base motivacional do uso da droga seria o sofrimento emocional. Como um todo, esse cenário permite pensar que a reforma psiquiátrica gerou transformações que promovem acolhimento, mas que ainda permanecem estigmas a serem superados.

Considering that clinical practices are based both on scientific knowledge and on beliefs and values that are not always conscious, this study aims to investigate the collective imagination of mental health professionals about the psychiatric patient, from the perspective of psychoanalytic concrete psychology. The importance of this study lies on the interest in improving the quality of care, considering both the benefit of patients and the improvement of professional practice conditions. Based on a collective psychological interview, articulated around the use of the Thematic Story-Drawing Procedure, we approached seven higher education professionals who work in mental health service. Consideration of the material allowed the interpretative production of two affective-emotional fields of meaning: "Psychotic sufferers" and "Dependent impostors". The overall picture shows the coexistence of sympathetic and ethical views toward the mentally psychotic with prejudiced and hostile views toward the drug-dependent. This contrast is mainly based on the difficulty in realizing that the motivational basis for drug use would be emotional suffering. As a whole, this scenario allows us to conclude that the psychiatric reform has brought about transformations that promote acceptance, but that stigmas to be overcome still remain.

Genomic characterization of Staphylococcus aureus from Canastra Minas Artisanal Cheeses.

Canastra Minas Artisanal Cheese is produced in the Brazilian State of Minas Gerais using raw milk, rennet, and pingo, a natural endogenous starter culture (fermented whey) collected from the previous day's production. Due to the use of raw milk, the product can carry microorganisms that may cause foodborne diseases (FBD), including Staphylococcus aureus. Genomic characterization of S. aureus is an important tool to assess diversity, virulence, antimicrobial resistance, and the potential for causing food poisoning due to enterotoxin production. This study is aimed at exploring the genomic features of S. aureus strains isolated from Canastra Minas Artisanal Cheeses. Multilocus sequence typing (MLST) classified these strains as ST1, ST5, and a new profile ST7849 (assigned to the clonal complex CC97). These strains belonged to four spa types: t008, t127, t359, and t992. We identified antimicrobial resistance genes with phenotypic correlation against methicillin (MRSA) and tetracycline. Virulome analysis revealed genes associated with iron uptake, immune evasion, and potential capacity for adherence and biofilm formation. The toxigenic potential included cyto- and exotoxins genes, and all strains presented the genes that encode for Panton-Valentine toxin and hemolysin, and two strains encoded 4 and 8 Staphylococcal enterotoxin (SE) genes. The results revealed the pathogenic potential of the evaluated S. aureus strains circulating in the Canastra region, representing a potential risk to public health. This study also provides useful information to monitor and guide the application of control measures to the artisanal dairy food production chain.

Unveiling Plant-Based Pectins: Exploring the Interplay of Direct Effects, Fermentation, and Technological Applications in Clinical Research with a Focus on the Chemical Structure.

Pectin, a plant-derived polysaccharide, possesses immense technological and biological application value. Several variables influence pectin's physicochemical aspects, resulting in different fermentations, interactions with receptors, and other functional properties. Some of those variables are molecular weight, degree of methylation and blockiness, and monosaccharide composition. Cancer cell cytotoxicity, important fermentation-related byproducts, immunomodulation, and technological application were found in cell culture, animal models, and preclinical and clinical assessments. One of the greater extents of recent pectin technological usage involves nanoencapsulation methods for many different compounds, ranging from chemotherapy and immunotherapy to natural extracts from fruits and other sources. Structural modification (modified pectin) is also utilized to enhance the use of dietary fiber. Although pectin is already recognized as a component of significant importance, there is still a need for a comprehensive review that delves into its intricate relationships with biological effects, which depend on the source and structure of pectin. This review covers all levels of clinical research, including cell culture, animal studies, and clinical trials, to understand how the plant source and pectin structures influence the biological effects in humans and some technological applications of pectin regarding human health.

Prospects on emerging eco-friendly and innovative technologies to add value to dry bean proteins.

The world's growing population and evolving food habits have created a need for alternative plant protein sources, with pulses playing a crucial role as healthy staple foods. Dry beans are high-protein pulses rich in essential amino acids like lysine and bioactive peptides. They have gathered attention for their nutritional quality and potential health benefits concerning metabolic syndrome. This review highlights dry bean proteins' nutritional quality, health benefits, and limitations, focusing on recent eco-friendly emerging technologies for their obtaining and functionalization. Antinutritional factors (ANFs) in bean proteins can affect their in vitro protein digestibility (IVPD), and lectins have been identified as potential allergens. Recently, eco-friendly emerging technologies such as ultrasound, microwaves, subcritical fluids, high-hydrostatic pressure, enzyme technology, and dry fractionation methods have been explored for extracting and functionalizing dry bean proteins. These technologies have shown promise in reducing ANFs, improving IVPD, and modifying allergen epitopes. Additionally, they enhance the techno-functional properties of bean proteins, making them more soluble, emulsifying, foaming, and gel-forming, with enhanced water and oil-holding capacities. By utilizing emerging innovative technologies, protein recovery from dry beans and the development of protein isolates can meet the demand for alternative protein sources while being eco-friendly, safe, and efficient.

Dry beans are a source of lysine-rich proteins and high-quality AA for the diet.Physical treatments can reduce the ANFs of beans and increase protein digestibility.Eco-friendly technologies can treat, modify, extract, and separate bean proteins.Conformational changes with protein unfolding improve WHC, EA, and solubility.The combined use of emerging technologies allows for conveying advantages of each one.

Black rice and its by-products: anthocyanin-rich extracts and their biological potential.

Recently, growing demand for products enriched with natural compounds that support human health has been observed. Black rice, its by-products, and residues are known to have in their composition a large amount of these compounds with biological potential, mainly anthocyanins. These compounds have reported effects on anti-obesity, antidiabetic, antimicrobial, anticancer, neuroprotective, and cardiovascular disease. Therefore, the extract from black rice or its by-products have great potential for application as ingredients in functional foods, supplements, or pharmacological formulations. This overview summarizes the methods employed for the extraction of anthocyanins from both black rice and its by-products. In addition, trends in applications of these extracts are also evaluated regarding their biological potential. Commonly, the extraction methods used to recover anthocyanins are conventional (maceration) and some emerging technologies (Ultrasound-Assisted Extraction - UAE, and Microwave-Assisted Extraction - MAE). Anthocyanin-rich extracts from black rice have presented a biological potential for human health. In vitro and in vivo assays (in mice) showed these compounds mainly with anti-cancer properties. However, more clinical trials are still needed to prove these potential biological effects. Extracts from black rice and its by-products have great potential in applying functional products with beneficial characteristics to humans and reducing agro-industrial residues.

Differential timing response of Herbivory-Induced Volatiles (HIPVs) in Croton floribundus Spreng. (Euphorbiaceae) / Resposta temporal diferencial de voláteis induzidos por herbivoria (HIPVs) em Croton floribundus Spreng. (Euphorbiaceae)

In this study, we demonstrated that Tetranychus urticae Koch (Acari: Tetranychidae), a generalist herbivore, induces volatile organic compounds (VOC) in Croton floribundus Spreng., a pioneer species widely used in Brazilian urban area. We performed experiments to evaluate the quality and quantity of VOC emission at different times (two, six and 24 hours and within four and nine days) of infestation by T. urticae. Results show that C. floribundus emitted 23 volatiles after infestation, including monoterpene, sesquiterpene and green leaf volatiles. Significant differences were only detected between infested and non-infested plants after 24 hours of treatment, in particular methyl salicylate. In contrast, 3-hexen-1ol, linaool, geranyl acetone and caryophyllene seem to be inhibited by hourly infestation. The α-farnesene, methyl salicylate, 3-carene, 3-hexen-1ol benzoate and nerolidol were the main compounds induced after four infestation-days. This study highlights that VOCs blends in C. floribundus is depended on the feeding time-course of T. urticae and suggests that the VOC-mediated ecological interaction may be less efficient in a pioneer species.

Neste estudo foi demonstrado que o Tetranychus urticae Koch (Acari: Tetranychidae), um herbívoro generalista, promove a emissão de compostos orgânicos voláteis (COV) em Croton floribundus (L.) Spreng., uma espécie pioneira amplamente utilizada na área urbana brasileira. Avaliou-se a qualidade e quantidade de emissão de COV em diferentes momentos (2, 6 e 24 horas e no intervalo de 4 e 9 dias) de infestação por T. urticae. Os resultados mostram que C. floribundus emitiu 23 voláteis após infestação, incluindo monoterpenos, sesquiterpenos e voláteis de folhas verdes. Diferenças significativas entre plantas infestadas e não infestadas foram detectadas após 24 horas de tratamento, em particular foram observadas alterações nos níveis de metil salicitato. Em contraste, o 3-hexen-1ol, linaool, geranil acetona e cariofileno parecem ter sido inibidos pela infestação horária. O α-farneseno, metil salicilato, 3-careno, benzoato de 3-hexen-1ol e nerolidol foram os principais compostos induzidos após quatro dias de infestação. Este estudo demonstra que o buquet de COVs emitido por C. floribundus depende do tempo de infestação da T. urticae e sugere que a interação ecológica mediada por COVs pode ser menos eficiente em espécie pioneira.

Enhanced production of surfactin using cassava wastewater and hydrophobic inducers: a prospection on new homologues.

Biosurfactants are amphipathic molecules that can be applied in a wide range of areas. The cost of production limits the industrial application of biosurfactants. Nevertheless, the biosurfactant productivity can be easily enhanced by inducers. This work aimed to investigate the effect of hydrophobic inducers on surfactin production by B. subtilis ATCC 6633 using cassava wastewater as low-cost culture medium. The submerged cultivation was carried out at 30 °C, 150 rpm for 72 h. The fermentation parameters used were bacterial growth, consumption of sugars, and surfactin production, including surfactin homologues. The surface tension decreased by 40% after 12 h, when compared to control. Depletion of sugars was observed in all experiments. Palmitic acid led to the highest yield in terms of surfactin production (≈ 1.3 g·L- 1 of pure surfactin). The inducers triggered the production of new surfactin homologues, that represent, potentially, new biological activities.

Care at the first postnatal hour in two hospitals of the Adequate Birth Project: qualitative analysis of experiences in two stages of the Healthy Birth research.

BACKGROUND:  The Adequate Childbirth Project (PPA) is a quality improvement project that aims to enhance normal delivery and reduce cesarean sections with no clinical indication in the Brazilian supplementary health care system. This study aims to analyze the care model of the first postpartum hour in hospitals that participated in the PPA. METHODS: Qualitative analysis based on the narrative of 102 women attended at two hospitals participating in the evaluative "Healthy Birth" research that analyzed the degree of implementation and the effects of the PPA. We assessed three practices within the first hour after delivery: skin-to-skin contact, breastfeeding and appropriate clamping of the umbilical cord. Data was collected through semi-structured interviews by telephone and submitted to thematic content analysis. RESULTS: The categories that emerged from the analysis of the results were "Dimension of time and care expressed in the lived experience" and "Interferences in care in the first hour of life". In the first category, women reported that in the first hour after delivery the newborn was placed on the mother's chest, but the length of time of the newborn's stay in skin-to-skin contact was less than one hour. This experience, even in a shorter period of time, was said to be positive by the women interviewed. Two barriers were observed: interruption of skin-to-skin contact for neonatal care and the transfer to the recovery room, both separating baby from mother without observing the duration of the "golden hour". It was identified that a process of improvement of the quality of care for childbirth is underway, with a gradual incorporation of recommended practices for care in newborn's first hour of life. CONCLUSIONS: Women reported access to the three care practices at two hospitals participating in the PPA quality improvement project. All practices were valued by women as a positive experience and should be promoted. Information during antenatal care to increase women´s autonomy, review of hospital practices to reduce barriers, and support from health care providers during the first hour after birth are needed to improve the implementation of these practices and access to their health benefits.

This study aims to analyze the care model of the first postpartum hour offered by two hospitals participating in the Adequate Childbirth Project (PPA), a quality improvement project to enhance normal delivery and reduce unnecessary cesarean sections in Brazilian private hospital. It is a qualitative analysis, based on the narrative of 102 women attended at two hospitals participating in the PPA. Categories that emerged from the analysis: "First hour; dimension of time and care expressed in the lived experience" and "Interferences in care in the first hour of life". Most women expressed a chronological time of skin-to-skin contact far from the ideal recommended in the first postpartum hour; however, they valued the experience and its meaning. Two barriers were observed in this care process: the interruption of skin-to-skin contact for neonatal care and the transfer to the recovery room, without observing the duration of the "golden hour". We can conclude that women evaluated the service positively, with indications that point to the sustainability of the PPA. Information during antenatal care to increase women´s autonomy are needed to improve the implementation of these practices and access to their health benefits.

Process of adhesion of the Adequate Childbirth Program to improve obstetric care in private hospitals in Brazil.

BACKGROUND: In 2015, a quality improvement project called "Projeto Parto Adequado-PPA" was implemented in Brazilian private hospitals to reduce unnecessary high rates of cesarean sections. This study aimed to analyze the decision-making process of managers and care leaders to adhere to the PPA. METHODS: The Healthy Birth study is evaluative research that used mixed methods to evaluate the implementation and effects of the Adequate Childbirth Program in 12 hospitals that participated in the program. Eight out of 12 hospitals were selected for a qualitative approach. We interviewed ten managers and 24 care leaders from July to October 2017. The interviews were transcripted, and data was systematized using the MaxQda software, with Thematic Content Analysis, to identify the facilitators and barriers for adherence to the Adequate Childbirth Program. We used the conceptions of the Diffusion of Innovation as an analytical reference. RESULTS: The main reasons to adhere to the Adequate Childbirth Program were the absence of other quality improvements programs in Brazilian private services using multifaceted interventions, social and market status for participating; commitment to quality of care; and the possibility of structural reforms related to the Adequate Childbirth Program implementation. In addition, inviting hospital influencers to learn about the objectives and intentions of the project before joining was considered an important strategy to motivate hospitals. CONCLUSION: Social, cultural, and economic constructs motivated adherence. The invitation strategy used by the Adequate Childbirth Program coordination, through socially respected members in Brazil, such as doctors, was highly valued by the leaders of the hospital team and encouraged adherence to the Program.

In 2015, a quality improvement program, called the "Adequate Childbirth Program" (PPA), was recommended by the National Supplementary Health Agency so that Brazilian private hospitals could, through a change in the care model, reduce unnecessary cesarean sections and stimulate the natural and safe process in childbirth. The process of adhering to the PPA was studied in this article. Ten managers and 24 assistant leaders were interviewed in 08 private hospitals in Brazil. The main reasons for joining the PPA were the absence of other quality improvement programs; for being a program considered necessary in the country's midwifery, which could increase the prestige of hospitals in the view of women and families; for proposing an improvement in the quality of care; and for stimulating of structural and ambiance reforms. Social, cultural, and economic values motivated hospital adherence. The invitation strategy used by the PPA coordination, through socially respected members in Brazil, such as medical professionals, was highly valued by the hospital's leaders and encouraged adherence to the Program.