Soil arthropod community responses to restoration in areas impacted by iron mining tailings deposition after Fundão dam failure.

In 2015, the failure of the Fundão dam in Mariana, Brazil released ~43 million m3 of iron mining tailings into the environment. Despite restoration initiatives in the following years, few studies-and most focused on revegetation-have evaluated the effectiveness of the restoration process in areas impacted by the disaster. We aimed to evaluate the responses of the arthropod community in areas impacted by iron mining tailings deposition from the Fundão dam that is in the restoration process. We defined sampling units in the riparian zone of the Gualaxo do Norte River, which is under restoration, and in a native not impacted riparian zone. We collected soil arthropods using pitfall traps and sampled environmental variables in the same sites. We used generalize least squares models (GLS) to test if the restored areas already presented values of arthropod diversity and functional group abundance similar to the reference area and to test which environmental variables are influencing arthropod diversity. We also tested how large the differences of arthropod community composition between the study areas and used the index of indicator species (IndVal) to verify which species could be used as an indicator of reference or restoration areas. The diversity of arthropods and the functional groups of detritivores and omnivores were higher in the native riparian zone. Understory density, soil density, organic matter content, and microbial biomass carbon were the environmental variables that significantly explained the diversity and species composition of arthropods. We show that restoration areas still have different soil arthropod diversity values and community composition when compared to reference areas. Evaluating the response of the arthropod community to the restoration process and long-term monitoring are essential to achieve a satisfactory result in this process and achieve a self-sustaining ecosystem.

Violência doméstica e seu impacto emocional sobre o adolescente: um estudo de revisão / Domestic violence and its emotional impact on adolescents: a review study / La violencia doméstica y su impacto emocional en los adolescentes: un estudio de revisión

Considerando a violência doméstica contra crianças e adolescentes como um problema social e de saúde pública que atinge milhares de famílias de todas as partes do mundo, o objetivo desta revisão de literatura é compreender o impacto emocional da violência doméstica na vida de adolescentes. Foram sele-cionados artigos científicos delimitados pelos descritores "domestic violence", "adolescent" e "emotional impact", nos idiomas português, inglês e espanhol, nas bases de dados Scielo, PsycINFO (APA) e Pubmed. Incluímos artigos empíricos avaliados por pares publicados nos últimos dez anos (2010- 2020). A partir da análise crítica dos 14 estudos selecionados identificamos que o impacto emocional da violência doméstica é resultado de uma complexa inte-ração entre fatores culturais, sociais, familiares e emocionais. De modo geral, o jovem vitimado apresenta sintomas depressivos, ansiedade e autoestima diminuída, a qual se revela por crenças negativas sobre si e sobre o mundo. Compreendemos a sintomatologia dos jovens como uma estratégia de sobre-vivência psíquica em ambientes familiares invasivos e negligentes quanto às suas necessidades físicas e emocionais. Concluímos pela necessidade de inter-venções preventivas e interventivas que objetivem tanto o bem estar de crianças e adolescentes quanto a oferta de um cuidado parental suficientemente bom. (AU)

Considering domestic violence against children and adolescents as a social and public health problem affecting thousands of families all over the world, the objective of this literature review is to understand the emotional impact of domestic violence on the lives of adolescents. Scientific articles delimited by the descriptors "domestic violence", "adolescent" and "emotional impact" were selected, in Portuguese, English and Spanish, in the Scielo, PsycINFO (APA) and Pubmed databases. We include peer- reviewed empirical articles published in the last ten years (2010-2020). Based on a critical analysis of 14 selected studies, we identified that the emotional impact of domestic violence is the result of a complex interaction between cultural, social, family and emotional factors. In general, the victimized youth presents depressive symptoms, anxiety and reduced self-esteem, which is revealed in negative beliefs about themselves and about the world. We understand the symptoms of young people as a psychic survival strategy in invasive family environments that neglect their physical and emotional needs. We conclude that there is a need for preventive and interventive actions aiming both at the well-being of children and adolescents and at offering a sufficiently good parental care.(AU)

Considerando la violencia intrafamiliar contra la niñez y adolescencia como un problema social y de salud pública afectando a miles de familias del mundo, el objetivo de esta revisión de literatura es comprender su impacto emocional en la vida de los adolescentes. Se seleccionaron artículos científicos delimitados por los descriptores "violencia doméstica", "adolescente" y "impacto emocional", en portugués, inglés y español, en las bases de datos Scielo, PsycINFO (APA) y Pubmed. Incluimos artículos empíricos revisados por pares publicados en los últimos diez años (2010-2020). A partir de un análisis crítico de 14 estudios seleccionados, identificamos que el impacto emocional de la violencia doméstica es el resultado de una interacción compleja entre factores culturales, sociales, familiares y emocionales. En general, el joven victimizado presenta síntomas depresivos, ansiedad y disminución de la autoestima, lo que se manifiesta en creencias negativas sobre sí mismos y el mundo. Entendemos los síntomas de los jóvenes como una estrategia de supervivencia psíquica en entornos familiares invasivos que descuidan sus necesidades físicas y emocionales. Concluimos que existe necesidad de intervenciones preventivas y intervencio-nistas apuntando tanto al bienestar de los niños y adolescentes como a ofrecer un cuidado parental suficientemente bueno. (AU)

Queimadura elétrica: Análise epidemiológica dos pacientes da Unidade de Queimados do Hospital de Clínicas da Universidade Federal de Uberlândia / Electrical burns: Epidemiological analysis of patients at the Burns Unit of the Hospital de Clínicas of the Federal University of Uberlândia

Introdução: O uso da corrente elétrica é imprescindível nas nossas atividades do cotidiano, porém, seu contato com tecidos vivos pode provocar queimaduras desde leves até graves ou fatais. Por se tratar de um problema de saúde pública, o conhecimento de sua epidemiologia é essencial para o desenvolvimento de programas em saúde. Método: Estudo transversal de dados registrados nos prontuários dos pacientes atendidos por queimadura elétrica na Unidade de Queimados do Hospital de Clínicas da Universidade Federal de Uberlândia entre os anos de 2013 e 2019. Resultados: Foram admitidos 26 pacientes, a maioria de sexo masculino (76,9%) e adultos (30,7%), vítimas de corrente de alta voltagem (65,4%) no trabalho (57,7%), que mais afetou as extremidades superiores (80,7%), sendo as crianças todas do sexo feminino (15,3%). O percentual médio de área queimada foi de 14,5% e o percentual de tratados com autoenxerto de pele foi de 53,8%. A média de permanência hospitalar foi de 40 dias e 3,8% deles foram para a Unidade de Terapia Intensiva. Não se registraram óbitos durante o período. Conclusão: A incidência de pacientes atendidos por queimadura elétrica é baixa, acometendo vítimas em todas as faixas etárias e com predomínio em indivíduos adultos do sexo masculino em seu local de trabalho. O tratamento cirúrgico mais realizado foi o autoenxerto de pele. As políticas de promoção, prevenção e proteção em saúde no que diz respeito aos perigos da corrente elétricas não estariam sendo praticadas e difundidas em nossa população doméstica, laboral ou empregadora, diferentemente como ocorre em grande parte dos países desenvolvidos.

Introduction: Using electric current is essential in our daily activities; however, its contact with living tissue can cause mild to severe or fatal burns. As it is a public health problem, knowledge of its epidemiology is essential for the development of health programs. Method: Cross-sectional study of data recorded in the medical records of patients treated for electrical burns at the Burns Unit of the Hospital de Clínicas of the Universidade Federal de Uberlândia between 2013 and 2019. Results: 26 patients were admitted, the majority of whom were male (76 .9%) and adults (30.7%), victims of high voltage current (65.4%) at work (57.7%), which most affected the upper extremities (80.7%), with children all female (15.3%). The average percentage of burned area was 14. 5% and the % of those treated with skin autograft was 53.8%. The average hospital stay was 40 days, and 3.8% went to the Intensive Care Unit. No deaths were recorded during the period. Conclusion: The incidence of patients treated for electrical burns is low, affecting victims in all age groups and with a predominance of adult males in their workplace. The most common surgical treatment was skin autograft. Health promotion, prevention, and protection policies regarding the dangers of electrical currents would not be practiced and disseminated among our domestic, working, or employing population, unlike what occurs in most developed countries.

Imidacloprid: Impact on Africanized Apis mellifera L. (Hymenoptera: Apidae) workers and honey contamination.

Apis mellifera L. (Hymenoptera: Apidae) is fundamental in the production chain, ensuring food diversity through the ecosystem service of pollination. The aim of this work was to evaluate the impact of imidacloprid, orally, topically, and by contact, on A. mellifera workers and to verify the presence of this active ingredient in honey. Toxicity levels were verified by bioassays. In bioassay 1, the levels correspond to the percentages of 100, 10, 1, 0.1, and 0.01% of the recommended concentration for field application of the commercial product Nortox® (active ingredient imidacloprid), with which we obtained the mean lethal concentration (LC50) in 48 h for A. mellifera, determining the concentration ranges to be used in the subsequent bioassays. Bioassays 2 and 3 followed the guidelines of the Organization for Economic Cooperation and Development, which specify the LC50 (48 h). In bioassay 4, the LC50 (48 h) and the survival rate of bees for a period of 120 h were determined by contact with a surface contaminated with imidacloprid, and in bioassay 5, the interference of the insecticide with the flight behavior of bees was evaluated. Honey samples were collected in agroecological and conventional georeferenced apiaries and traces of the imidacloprid were detected by means of high-performance liquid chromatography (HPLC-UV) with extraction by SPE C18. Bee survival was directly affected by the concentration and exposure time, as well behavioral performance, demonstrating the residual effect of imidacloprid on A. mellifera workers. Honey samples from a conventional apiary showed detection above the maximum residue limits (MRL) allowed by the European Union (0.05 µg mL-1), but samples from other apiaries showed no traces of this insecticide. Imidacloprid affects the survival rate and behavior of Africanized A. mellifera and honey quality.

Metastatic Sertoli cell tumour in a captive giant anteater (Myrmecophaga tridactyla).

There are a few studies on diseases of anteaters, but reports on reproductive lesions and neoplasms of these animals are scarce. This is the first report of a case of metastatic Sertoli cell tumour in a giant anteater (Myrmecophaga tridactyla). The animal had renal lesions associated with impaired renal function as indicated by serum biochemistry. Histopathological and immunohistochemical examinations provided a conclusive diagnosis of Sertoli cell tumour with metastasis to the liver, kidneys and lymph nodes.

Mental Health and Emotional Disorders During the COVID-19 Pandemics: Prevalence and Extent in PICU Staff.

OBJECTIVES: To assess the prevalence of burnout, anxiety and depression symptoms, and posttraumatic stress disorder (PTSD) in PICU workers in Brazil during the first peak of the COVID-19 pandemic. To compare the results of subgroups stratified by age, gender, professional category, health system, and previous mental health disorders. DESIGN: Multicenter, cross-sectional study using an electronic survey. SETTING: Twenty-nine public and private Brazilian PICUs. SUBJECTS: Multidisciplinary PICU workers. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Self-reported questionnaires were used to measure burnout (Maslach Burnout Inventory), anxiety and depression (Hospital Anxiety and Depression Scale), and PTSD (Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PCL-5]) in 1,084 respondents. Subjects were mainly young (37.1 ± 8.4 yr old) and females (85%), with a median workload of 50 hours per week. The prevalence of anxiety and depression was 33% and 19%, respectively, whereas PTSD was 13%. The overall median burnout scores were high in the emotional exhaustion and personal accomplishment dimensions (16 [interquartile range (IQR), 8-24] and 40 [IQR, 33-44], respectively) whereas low in the depersonalization one (2 [IQR, 0-5]), suggesting a profile of overextended professionals, with a burnout prevalence of 24%. Professionals reporting prior mental health disorders had higher prevalence of burnout (30% vs 22%; p = 0.02), anxiety (51% vs 29%; p < 0.001), and depression symptoms (32.5% vs 15%; p < 0.001), with superior PCL-5 scores for PTSD ( p < 0.001). Public hospital workers presented more burnout (29% vs 18.6%, p < 0.001) and more PTSD levels (14.8% vs 10%, p = 0.03). Younger professionals were also more burned out ( p < 0.05 in all three dimensions). CONCLUSIONS: The prevalence of mental health disorders in Brazilian PICU workers during the first 2020 peak of COVID-19 was as high as those described in adult ICU workers. Some subgroups, particularly those reporting previous mental disorders and younger professionals, should receive special attention to prevent future crises.

The Challenging Management of Acute Thrombotic Microangiopathy in Pregnancy.

Thrombotic microangiopathy is characterized by microangiopathic hemolytic anemia, thrombocytopenia, and end-organ injury. Pregnancy-associated thrombotic microangiopathy is a severe disorder with a high risk of maternal mortality and poor fetal outcomes. Preeclampsia/eclampsia and hemolysis, elevated liver enzymes, and low platelets syndrome are the most common causes, and hemolytic uremic syndrome or thrombotic thrombocytopenic purpura are rare causes. Due to overlapping clinical findings, the differential diagnosis is challenging and should be managed by a multidisciplinary team. We present a case of a 38-year-old woman at 40 weeks of second gestation, admitted with thrombotic microangiopathy being the final diagnosis not immediately clear.

Mamoplastia redutora: da técnica ao impacto social / Reduction mammoplasty: from technique to social impact / Mamoplastia de reducción: de la técnica al impacto social

As mulheres com tamanhos excessivos das mamas sofrem de patologias definidas como gigantomastia, macromastia ou hipertrofia mamária, isso indica um processo em que os seios são patologicamente aumentados o que gera condições insalubres. Seu tamanho afeta diretamente sua saúde com danos psicológicos e na qualidade de vida. O tratamento inclui a retirada cirúrgica do tecido excedente no processo de melhora da qualidade de vida, visando reduzir os sintomas, melhorar a funcionalidade, o estado psicológico, além um melhoramento estético. Dessa forma, o presente estudo tem como objetivo realizar uma análise desde a técnica da mamoplastia redutora quanto aos seus impactos sociais. Trata-se de uma pesquisa qualitativa como foco a construção teórica e a discussão de questões atuais sobre o tema com base nas evidências das literaturas dos últimos cinco anos. As mulheres com gigantomastia experimentam melhorias na forma e funcionalidade da mama após a mamoplastia redutora. Há evidências substanciais de que esta cirurgia melhora significativamente a qualidade de vida do paciente, visto que há a redução do volume mamário que consequentemente melhora das dores lombares, as mamas ficam esteticamente mais adequadas para uso de roupas íntimas, além de cessar irritações cutâneas e infecções nas áreas das dobras. Muitas pacientes se beneficiam de uma melhor qualidade de vida ao não apresentarem mais esses sintomas listados. Realizar este procedimento tem sido considerado satisfatório pela maioria das pessoas, e com base na análise realizada, a maioria das pacientes priorizam os efeitos estéticos e funcional, além de reduzir o impacto em outras doenças mesmo essa patologia não sendo amplamente disponibilizada pelo SUS. De tal forma, essa direção de pesquisa busca contribuir para o desenvolvimento de pesquisas futuras e em andamento relacionadas a esse tema.

Women with excessive breast sizes suffer from pathologies defined as gigantomastia, macromastia, or breast hypertrophy, this indicates a process in which the breasts are pathologically enlarged which generates unhealthy conditions. Their size directly affects your health with psychological damage and quality of life. The treatment includes the surgical removal of the excess tissue in the process of improving quality of life, aiming to reduce symptoms, improve functionality, psychological state, and an aesthetic improvement. Thus, the present study aims to carry out an analysis from the technique of reduction mammoplasty as to its social impacts. This is a qualitative research focusing on theoretical construction and discussion of current issues on the subject based on evidence from the literatures of the last five years. Women with gigantomastia experience improvements in breast shape and functionality after reduction mammaplasty. There is substantial evidence that this surgery significantly improves the patient's quality of life, as there is a reduction in breast volume which consequently improves lower back pain, the breasts become more aesthetically pleasing for underwear, and skin irritation and infections in the fold areas cease. Many patients benefit from a better quality of life by no longer experiencing these listed symptoms. Performing this procedure has been considered satisfactory by most people, and based on the analysis performed, most patients prioritize the aesthetic and functional effects, besides reducing the impact on other diseases even though this pathology is not widely available by SUS. In such a way, this research direction seeks to contribute to the development of future and ongoing research related to this theme.

Las mujeres con excesivo tamaño mamario sufren patologías definidas como gigantomastia, macromastia o hipertrofia mamaria, esto indica un proceso en el que las mamas se agrandan patológicamente lo que genera condiciones insalubres. Su tamaño afecta directamente a la salud con daños psicológicos y a la calidad de vida. El tratamiento incluye la extirpación quirúrgica del exceso de tejido en el proceso de mejora de la calidad de vida, con el objetivo de reducir los síntomas, mejorar la funcionalidad, el estado psicológico, y una mejora estética. Así, el presente estudio pretende realizar un análisis a partir de la técnica de mamoplastia de reducción en cuanto a sus impactos sociales. Se trata de una investigación cualitativa centrada en la construcción teórica y la discusión de cuestiones actuales sobre el tema a partir de la evidencia de las literaturas de los últimos cinco años. Las mujeres con gigantomastia experimentan mejoras en la forma y funcionalidad de las mamas después de la mamoplastia de reducción. Existen pruebas sustanciales de que esta cirugía mejora significativamente la calidad de vida de la paciente, ya que se produce una reducción del volumen mamario que, en consecuencia, mejora el dolor lumbar, las mamas resultan más estéticas para la ropa interior y cesan la irritación de la piel y las infecciones en las zonas de los pliegues. Muchas pacientes se benefician de una mejor calidad de vida al dejar de experimentar estos síntomas enumerados. La realización de este procedimiento ha sido considerada satisfactoria por la mayoría de las personas, y con base en el análisis realizado, la mayoría de los pacientes priorizan los efectos estéticos y funcionales, además de reducir el impacto sobre otras enfermedades, aunque esta patología no esté ampliamente disponible por el SUS. De tal forma, esta dirección de investigación busca contribuir para el desarrollo de futuras y actuales investigaciones relacionadas a este tema.

Interpretable surface-based detection of focal cortical dysplasias: a Multi-centre Epilepsy Lesion Detection study.

One outstanding challenge for machine learning in diagnostic biomedical imaging is algorithm interpretability. A key application is the identification of subtle epileptogenic focal cortical dysplasias (FCDs) from structural MRI. FCDs are difficult to visualize on structural MRI but are often amenable to surgical resection. We aimed to develop an open-source, interpretable, surface-based machine-learning algorithm to automatically identify FCDs on heterogeneous structural MRI data from epilepsy surgery centres worldwide. The Multi-centre Epilepsy Lesion Detection (MELD) Project collated and harmonized a retrospective MRI cohort of 1015 participants, 618 patients with focal FCD-related epilepsy and 397 controls, from 22 epilepsy centres worldwide. We created a neural network for FCD detection based on 33 surface-based features. The network was trained and cross-validated on 50% of the total cohort and tested on the remaining 50% as well as on 2 independent test sites. Multidimensional feature analysis and integrated gradient saliencies were used to interrogate network performance. Our pipeline outputs individual patient reports, which identify the location of predicted lesions, alongside their imaging features and relative saliency to the classifier. On a restricted 'gold-standard' subcohort of seizure-free patients with FCD type IIB who had T1 and fluid-attenuated inversion recovery MRI data, the MELD FCD surface-based algorithm had a sensitivity of 85%. Across the entire withheld test cohort the sensitivity was 59% and specificity was 54%. After including a border zone around lesions, to account for uncertainty around the borders of manually delineated lesion masks, the sensitivity was 67%. This multicentre, multinational study with open access protocols and code has developed a robust and interpretable machine-learning algorithm for automated detection of focal cortical dysplasias, giving physicians greater confidence in the identification of subtle MRI lesions in individuals with epilepsy.

Ketogenic diet, epilepsy and cognition: what do we know so far? A systematic review.

CONTEXT: Epilepsy is a chronic neurological disorder that has social, cognitive, and psychological consequences to the patient. OBJECTIVE: The effects of the ketogenic diet (KD) in children and adults with pharmacoresistant epilepsy on cognitive function were evaluated in this systematic review. DATA SOURCES: The MEDLINE, Cochrane Library, Scopus, Web of Science, and LILACS databases were searched up to February 2021. STUDY SELECTION AND DATA EXTRACTION: From the 2973 records initially identified, 24 studies were included in the systematic review. These records were screened via PICO criteria, focusing on studies that evaluated the effects of KD on cognitive function of patients with pharmacoresistant epilepsy. RESULTS: Nineteen studies described improvements in cognitive function attributed to KD; improvements were not observed in 2 studies, but neither was aggravation. Contradictory results were reported in 3 studies, depending on the method used to assess cognition. At first glance, cognitive function appears to be associated with the number of seizures, diet effectiveness, amount of carbohydrate ingested, and antiseizure medication used. However, due to the diversity of methods used to assess cognitive function, especially self-perception of cognitive improvement by the patient, it was not possible to confirm this hypothesis. CONCLUSION: It was not possible to confirm if KD itself promotes improvements in cognitive function in patients with pharmacoresistant epilepsy. Certainly, more studies are needed with better methodological quality, larger and more homogeneous samples in relation to epileptic syndrome and clinical aspects of the disease, more rigid monitoring of adherence to the diet, and use of standardized tests for neuropsychological assessment. Systematic Review Registration: PROSPERO registration no. CRD42019129236.

Relationship between lymphedema after breast cancer treatment and biophysical characteristics of the affected tissue.

The treatment of breast cancer is often complicated by lymphedema of the upper limbs. Standard lymphedema evaluation methodologies are not able to measure tissue fibrosis. The ultrasound aspects related to tissue microstructures of lymphedema are neglected in clinical evaluations. The objective of this study was to identify and measure the degree of impairment, topography, and biophysical alterations of subcutaneous lymphedema tissue secondary to the treatment of breast cancer by ultrasonography. Forty-two women at a mean age of 58 (±9.7) years, with unilateral lymphedema due to breast cancer treatment, were evaluated. The upper limbs were divided into affected (affected by lymphedema) and control (contralateral limb). Each limb was subdivided into seven areas, defined by perimetry, evaluated in pairs. The biophysical characteristics thickness, entropy, and echogenicity were evaluated by ultrasonography. The results showed a significant difference in the echogenicity and thickness variables between the affected and unaffected upper limb, in all the extent of the upper limb, while entropy showed no significant difference. The findings indicate that the data presented were consistent both in identifying and measuring the degree of impairment and biophysical changes in the subcutaneous tissue of lymphedema secondary to the treatment of breast cancer.

Pediatric Sepsis Research: Where Are We and Where Are We Going?

Sepsis continues to be one of the leading causes of admission to the Pediatric Intensive Care Unit, representing a great challenge for researchers and healthcare staff. This mini review aims to assess research on pediatric sepsis over the years. Of the 2,698 articles retrieved from the Scopus database, the 100 most cited were selected (50 published since 2000 and 50 published since 2016). The most cited studies, published in the 21st century, are highlighted, with their main findings and perspectives.

Multicenter validation of PIM3 and PIM2 in Brazilian pediatric intensive care units.

Objective: To validate the PIM3 score in Brazilian PICUs and compare its performance with the PIM2. Methods: Observational, retrospective, multicenter study, including patients younger than 16 years old admitted consecutively from October 2013 to September 2019. We assessed the Standardized Mortality Ratio (SMR), the discrimination capability (using the area under the receiver operating characteristic curve - AUROC), and the calibration. To assess the calibration, we used the calibration belt, which is a curve that represents the correlation of predicted and observed values and their 95% Confidence Interval (CI) through all the risk ranges. We also analyzed the performance of both scores in three periods: 2013-2015, 2015-2017, and 2017-2019. Results: 41,541 patients from 22 PICUs were included. Most patients aged less than 24 months (58.4%) and were admitted for medical conditions (88.6%) (respiratory conditions = 53.8%). Invasive mechanical ventilation was used in 5.8%. The median PICU length of stay was three days (IQR, 2-5), and the observed mortality was 1.8% (763 deaths). The predicted mortality by PIM3 was 1.8% (SMR 1.00; 95% CI 0.94-1.08) and by PIM2 was 2.1% (SMR 0.90; 95% CI 0.83-0.96). Both scores had good discrimination (PIM3 AUROC = 0.88 and PIM2 AUROC = 0.89). In calibration analysis, both scores overestimated mortality in the 0%-3% risk range, PIM3 tended to underestimate mortality in medium-risk patients (9%-46% risk range), and PIM2 also overestimated mortality in high-risk patients (70%-100% mortality risk). Conclusions: Both scores had a good discrimination ability but poor calibration in different ranges, which deteriorated over time in the population studied.

Percepções de educadoras ao Papanicolau entrelaçadas às questões de corpo / Perceptions of educators to the Papanicolau interlated to body issues / Percepciones de los educadores al Papanicolau interlados con temas corporales

Objetivo: apreender as percepções de educadoras sobre o Papanicolau associadas às questões de corpo. Método: qualitativo, exploratório e descritivo realizado com 18 educadoras de uma escola pública em Petrolina-PE, após aprovação pelo Comitê de Ética, parecer nº 4.048.369. Empregou-se o recurso gráfico, juntamente, à entrevista semi-estruturada, tratados pela análise semiológica de imagem e pela análise temática de conteúdo. Resultados: as educadoras conhecem a importância do exame, mas apresentaram superficialidade sobre o objetivo e materiais utilizados, além de sentimentos negativos como constrangimento, dor, desconforto, dentre outros. Logo, o profissional de saúde precisa considerar as especificidades femininas para a escolha do material, assim como, valorizar o que cada corpo pode sentir e falar, independente das queixas. Conclusão: assim, sob uma perspectiva reducionista percebe-se que um corpo que fala é silenciado pelas dimensões de descuido e não de cuidado em saúde

Objective: to apprehend the perceptions of educators about Pap smears associated with body issues. Method: qualitative, exploratory and descriptive carried out with 18 educators from a public school in Petrolina-PE, after approval by the Ethics Committee, opinion nº 4.048.369. The graphic resource was used, together with the semi-structured interview, treated by the semiological image analysis and the thematic content analysis. Results: the educators know the importance of the exam, but they were superficial about the purpose and materials used, in addition to negative feelings such as embarrassment, pain, discomfort, among others. Therefore, the health professional needs to consider women's specificities when choosing the material, as well as valuing what each body can feel and say, regardless of the complaints. Conclusion: thus, from a reductionist perspective, it is perceived that a speaking body is silenced by the dimensions of carelessness and not health care

Objetivo: comprender las percepciones de los educadores sobre las pruebas de Papanicolaou asociadas a problemas corporales. Método: cualitativo, exploratorio y descriptivo realizado con 18 educadores de un colegio público de Petrolina-PE, previa aprobación del Comité de Ética, dictamen nº 4.048.369. Se utilizó el recurso gráfico, junto con la entrevista semiestructurada, tratado por el análisis de imagen semiológico y el análisis de contenido temático. Resultados: los educadores conocen la importancia del examen, pero fueron superficiales sobre el propósito y los materiales utilizados, además de sentimientos negativos como vergüenza, dolor, malestar, entre otros. Por tanto, el profesional de la salud debe tener en cuenta las especificidades de las mujeres a la hora de elegir el material, así como valorar lo que cada cuerpo puede sentir y decir, independientemente de las quejas. Conclusión: así, desde una perspectiva reduccionista, se percibe que un cuerpo hablante es silenciado por las dimensiones del descuido y no del cuidado de la salud

Preconceito e parentalidade? Experiências de casais homoafetivos: experiences of homoaffective couples / Prejudice and parenthood: experiencias de parejas homoafectivas / Prejuicio y parentalidad

Diferentes configurações familiares têm surgido na contemporaneidade em decorrência de avanços sociais. Entre as parentalidades emergentes, a homoparentalidade é a que mais se distancia do ideal social, já que evidencia a orientação sexual dos pais e mobiliza fantasias de que ela interfira no exercício parental e no desenvolvimento de seus filhos. Por esta razão, investigamos a experiência emocional de casais homoafetivos em relação ao preconceito vivenciado no exercício da parentalidade. Para isso, adotamos uma abordagem qualitativa psicanalítica e entrevistamos seis casais homoafetivos, fazendo uso de uma Narrativa Interativa, dado seu potencial de acesso lúdico e protegido à experiência emocional dos participantes. A análise interpretativa do material narrativo resultou em campos de sentidos afetivo-emocionais dos quais o campo "Que família é essa?" emerge como emblemático do preconceito sofrido pela família homoparental em decorrência de uma visão patriarcal e heteronormativa da sociedade. Embora os casais homoafetivos reproduzam em certa medida o padrão familiar heterossexual, seu modo de exercer a parentalidade aponta para alternativas criativas e levanta novos questionamentos.

Different family configurations have emerged in contemporary times due to social advancements. Among the emergent parenting, homoparenting is the one that distances itself from the social ideal the most, as it evidences the parents' sexual orientation and mobilizes fantasies that it interferes with the parenting exercise and their children's development. For this reason, we investigate the emotional experience of homoaffective couples regarding the prejudice experienced in parenting exercise. For this, we adopted a qualitative psychoanalytic approach, and we interviewed six homoaffective couples, making use of an Interactive Narrative, given its potential for ludic and protected access to the emotional experience of the participants. The interpretive analysis of the narrative material has resulted in fields of affective-emotional meaning, from which the "What family is this?" field emerges as emblematic of the prejudice suffered by the homoparental family as a result of a patriarchal and heteronormative view from society. Although homoaffective couples to some extent reproduce the heterosexual family pattern, their way of parenting exercise point out to creative alternatives and raise new questions.

Diferentes configuraciones familiares han surgido en los tiempos contemporáneos como resultado de avances sociales. Entre las paternidades emergentes, la homoparentalidad es la más alejada del ideal social, ya que destaca la orientación sexual de los padres y moviliza fantasías de ella interfiriendo en el ejercicio parental y en el desarrollo de sus hijos. Por esta razón, investigamos la experiencia emocional de parejas homoafetivas en relación al prejuicio experimentado en el ejercicio de la parentalidad. Para esto, adoptamos un enfoque psicoanalítico cualitativo y entrevistamos a seis parejas homoafetivas, haciendo uso de una Narrativa Interactiva, dado su potencial para el acceso lúdico y protegido a la experiencia emocional de los participantes. El análisis interpretativo del material narrativo ha dado como resultado campos de significados afectivo-emocionales de los cuales el campo "¿Que familia es esta?" emerge como un emblema del prejuicio sufrido por la familia homoparental como resultado de una visión patriarcal y heteronormativa de la sociedad. Aunque las parejas homoafetivas reproducen hasta cierto punto el patrón familiar heterosexual, su modo de ejercer la parentalidad apunta a alternativas creativas y plantean nuevas preguntas.

GWAS Identifies a Region Containing the SALL1 Gene in Variation of Pigmentation Intensity Within the Chestnut Coat Color of Horses.

Chestnut coat color in horses is determined by a missense mutation within the MC1R gene. However, the intensity of the chestnut color can vary widely within individuals possessing this genotype. Here, we investigated this variation using standardized photographs of 96 horses. Each horse was ranked lightest to darkest within the cohort for phenotype by 3 blinded observers. A genome-wide association study utilizing the relative shade ranking as the phenotype and using 268 487 single-nucleotide polymorphisms (SNPs) genotyped using the Affymetrix Equine 670k array identified a single significantly associated region on chromosome 3 (P = 2.934 × 10-8). Analysis of whole-genome sequences for horses spanning the diverse range of chestnut color identified candidate SNPs within the coding sequence of the only gene in the region: SALL1. The function of SALL1 is largely unknown, though it is predicted to interact with the Hermansky-Pudlak Syndrome type 1 (HPS1) protein, which causes partial albinism in humans. However, with only one study suggesting a circumstantial influence of the SALL1 protein on pigmentation, additional work is needed to confirm this new coat color locus in larger populations and investigate the function of this protein for impacts on equine health.

International Multicenter Analysis of Brain Structure Across Clinical Stages of Parkinson's Disease.

BACKGROUND: Brain structure abnormalities throughout the course of Parkinson's disease have yet to be fully elucidated. OBJECTIVE: Using a multicenter approach and harmonized analysis methods, we aimed to shed light on Parkinson's disease stage-specific profiles of pathology, as suggested by in vivo neuroimaging. METHODS: Individual brain MRI and clinical data from 2357 Parkinson's disease patients and 1182 healthy controls were collected from 19 sources. We analyzed regional cortical thickness, cortical surface area, and subcortical volume using mixed-effects models. Patients grouped according to Hoehn and Yahr stage were compared with age- and sex-matched controls. Within the patient sample, we investigated associations with Montreal Cognitive Assessment score. RESULTS: Overall, patients showed a thinner cortex in 38 of 68 regions compared with controls (dmax  = -0.20, dmin  = -0.09). The bilateral putamen (dleft  = -0.14, dright  = -0.14) and left amygdala (d = -0.13) were smaller in patients, whereas the left thalamus was larger (d = 0.13). Analysis of staging demonstrated an initial presentation of thinner occipital, parietal, and temporal cortices, extending toward rostrally located cortical regions with increased disease severity. From stage 2 and onward, the bilateral putamen and amygdala were consistently smaller with larger differences denoting each increment. Poorer cognition was associated with widespread cortical thinning and lower volumes of core limbic structures. CONCLUSIONS: Our findings offer robust and novel imaging signatures that are generally incremental across but in certain regions specific to disease stages. Our findings highlight the importance of adequately powered multicenter collaborations. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Estratégias para o desenvolvimento de empatia em enfermagem: Rapid review / Strategies for the development of empathy in nursing: Rapid review / Estrategias para el desarrollo de la empatía en enfermería: Rapid review

Resumo Introdução: A empatia é considerada uma competência clínica importante no desenvolvimento de profissionais da área da saúde e, está diretamente relacionada ao sucesso das intervenções em saúde. Objetivo: O objetivo desta pesquisa foi identificar métodos para o desenvolvimento de empatia no ensino em enfermagem por meio de uma rapid review. Métodos: Foi realizada uma rapid review em revistas com relevância no tema de educação em enfermagem. Resultados: Encontraram-se 190 artigos e foram selecionados 21 artigos para análise qualitativa, respeitando os critérios de inclusão e exclusão propostos. Entre os resultados, identificaram-se sete tipos de metodologias diferentes para aplicação no aprendizado, dentre elas, a simulação é tida como estratégia principal, visando experiências próximas à realidade. Evidenciou-se também o uso das artes como poema, storytelling e músicas. Conclusões: Conclui-se que devido à importância da enfermagem diante da vulnerabilidade humana, há a necessidade de métodos que perpetuem a empatia no decorrer da graduação, para melhoria do cuidado.

Abstract Background: Empathy is considered an important clinical competence for the Development of health professionals. The empathy is directly related to the quality of health interventions. Aim: The objective of this research was identify methods for teaching empathy in teaching nursing through a rapid review. Methods: A rapid review was carried out in journals with relevance to the theme of nursing education. Results: Was listed 190 articles from the journals them 21 articles were selected for qualitative analysis, according the criterion of exclusion and inclusion. In the results, seven different methods of learning application were found. They approached simulation as their main strategy, looking experiences similar to reality, the use of the arts as poem, storytelling and music was also evidenced like methods of learning. Conclusions: It is concluded that due to the importance of nursing in relation to human vulnerability, methods that perpetuate empathy during graduation are needed to improve science of care.

Resumen Contexto: La empatía se considera una competencia clínica importante para el desarollo de profesionales de la salud y está directamente relacionada con éxito en las intervenciones de salud. Objetivo: El objetivo de esta investigación fue identificar métodos para enseñar empatía en enseñando en enfermería a través de una rapid review. Metodología: Se realizó una revisión rápida en revistas con relevancia para el tema de la formación en enfermería. Resultados: se encontraron 190 artículos y se seleccionaron 21 artículos para el análisis cualitativo, respetando los criterios de inclusión y exclusión propuestos. Entre los resultados, encontramos siete metodologías diferentes para la aplicación del aprendizaje, entre ellas, la simulación se considera como la estrategia principal, apuntando a experiencias cercanas a la realidad, así como el uso de las artes como poema, narración de cuentos y música. Conclusiones: Se concluye que debido a la importancia de la enfermería frente a la vulnerabilidad humana, existe la necesidad de métodos que perpetúen la empatía durante la graduación, para mejorar la atención.

Cross-cultural adaptation of the Richmond Agitation-Sedation Scale to Brazilian Portuguese for the evaluation of sedation in pediatric intensive care. / Adaptação transcultural para o Brasil da Richmond Agitation-Sedation Scale para avaliação da sedação em terapia intensiva pediátrica.

OBJECTIVE: To perform a cross-cultural adaptation of the Richmond Agitation-Sedation Scale (RASS) to Brazilian Portuguese for the evaluation of sedation in pediatric intensive care. METHODS: Cross-cultural adaptation process including the conceptual, item, semantic and operational equivalence stages according to current recommendations. RESULTS: Pretests, divided into two stages, included 30 professionals from the pediatric intensive care unit of a university hospital, who administered the translated RASS to patients aged 29 days to 18 years. The pretests showed a content validity index above 0.90 for all items: 0.97 in the first stage of pretests and 0.99 in the second. CONCLUSION: The cross-cultural adaptation of RASS to Brazilian Portuguese resulted in a version with excellent comprehensibility and acceptability in a pediatric intensive care setting. Reliability and validity studies should be performed to evaluate the psychometric properties of the Brazilian Portuguese version of the RASS.

OBJETIVO: Realizar adaptação transcultural para o Brasil da Richmond Agitation-Sedation Scale (RASS) para avaliação da sedação em terapia intensiva pediátrica. MÉTODOS: Processo de adaptação transcultural incluindo as etapas de equivalência conceitual, de itens, semântica e operacional, de acordo com recomendações atuais. RESULTADOS: Pré-testes, divididos em duas etapas, incluíram 30 profissionais da unidade de terapia intensiva pediátrica de um hospital universitário, que aplicaram a RASS traduzida em pacientes de 29 dias a 18 anos. Os pré-testes mostraram Índice de Validade de Conteúdo acima de 0,90 para todos os itens: 0,97 na primeira etapa de pré-testes e 0,99 na segunda. CONCLUSÃO: A adaptação transcultural da RASS para o português do Brasil resultou em versão com excelente compreensão e aceitabilidade em cenário de terapia intensiva pediátrica. Estudos de confiabilidade e de validade devem ser realizados para avaliar as propriedades psicométricas da versão adaptada para o português do Brasil da RASS.

Sofrimento de mulheres em situação de vulnerabilidade durante a pandemia de COVID-19 / Suffering of women in vulnerability situation during COVID-19 pandemic

Diante da situação de crise desencadeada pela pandemia de Covid-19, o isolamento social tem sido uma das estratégias de prevenção do contágio. Como a pandemia vem se estendendo por muitos meses, e consequentemente o confinamento das pessoas em suas residências, conflitos no campo das relações familiares são potencializados e geram sofrimento. Tal quadro nos leva a supor o aprofundamento do sofrimento emocional de mulheres que vivem diferentes situações de vulnerabilidade durante a pandemia. Por essa razão, o presente estudo propõe uma revisão narrativa que objetiva refletir sobre cinco experiências de vulnerabilidade que nos parecem emblemáticas do sofrimento da mulher que vive o drama da violência doméstica, da LGBTQI+ fobia, do consumo de álcool e drogas, da gestação, parto e puerpério e, finalmente, do diagnóstico e tratamento de câncer de mama. Realizamos uma reflexão psicanalítica winnicottiana a respeito das falhas ambientais e da experiência de solidão que caracterizam a vivência de mulheres expostas a situações de opressão e/ou medo em sua intersecção com a constante ameaça de contágio pelo novo Coronavírus. Destacamos a necessidade de intervenções psicossociais que estejam afinadas às necessidades das mulheres que se mostraram amplificadas pela atual conjuntura de quarentena e isolamento social.(AU)

In view of the crisis situation triggered by the Covid-19 pandemic, social isolation has been one of the strategies for preventing contagion. As the pandemic has been going on for many months, and consequently the confinement of people in their homes, conflicts in the field of family relationships are potentiated and generate suffering. This situation leads us to suppose the deepening of the emotional suffering of women who experience different situations of vulnerability during the pandemic. For this reason, this study proposes a narrative review that aims to reflect on five experiences of vulnerability that seem to us emblematic of the suffering of women who live the drama of domestic violence, LGBTQI + phobia, alcohol and drug consumption, pregnancy, childbirth and puerperium and, finally, the diagnosis and treatment of breast cancer. We carried out a winnicottian psychoanalytic reflection on the environmental flaws and the experience of loneliness that characterize the experience of women exposed to situations of oppression and / or fear at its intersection with the constant threat of contagion by the new Coronavirus. We highlight the need for psychosocial interventions that are in tune with the needs of women who have been amplified by the current situation of quarantine and social isolation.(AU)

Ante la situación de crisis desencadenada por la pandemia Covid-19, el aislamiento social ha sido una de las estrategias para prevenir el contagio. Como la pandemia se viene desarrollando hace muchos meses, y por consiguiente el confinamiento de personas en sus hogares, los conflictos en el ámbito de las relaciones familiares se potencian y generan sufrimiento. Esta situación nos lleva a suponer la profundización del sufrimiento emocional de las mujeres que viven distintas situaciones de vulnerabilidad durante la pandemia. Por ello, este estudio propone una revisión narrativa que tiene como objetivo reflexionar sobre cinco experiencias de vulnerabilidad que nos parecen emblemáticas del sufrimiento de mujeres viviendo el drama de la violencia intrafamiliar, fobia LGBTQI +, consumo de alcohol y drogas, embarazo, parto y puerperio y, finalmente, el diagnóstico y tratamiento del cáncer de mama. Realizamos una reflexión psicoanalítica winnicottiana sobre las fallas ambientales y la experiencia de soledad que caracterizan la vivencia de mujeres expuestas a situaciones de opresión y / o miedo en su intersección con la constante amenaza de contagio por el nuevo Coronavirus. Destacamos la necesidad de intervenciones psicosociales en sintonía con necesidades de mujeres amplificadas por la situación actual de cuarentena y aislamiento social.(AU)