Understanding quality of life's challenges in sarcoma patients: A mixed-methods study.

PURPOSE: Sarcoma, a highly aggressive form of cancer, profoundly affects patients both physically and psychologically. This study aimed to assess sarcoma patients' health-related quality of life and explore their experiences of living with the disease and their specific care requirements. METHODS: This research employed a convergent parallel mixed-methods design. Fifty-two sarcoma patients completed the European Portuguese version of the EORTC QLQ-C30 questionnaire, and seven of them participated in semi-structured interviews. Descriptive measures, Cronbach alpha for internal consistency, t-teste-Anova and stepwise regression were employed in the quantitative analysis. Qualitative data was analysed thematically. RESULTS: The most affected Quality of life (QoL) dimensions were role functioning and global health, areas of functioning that were also described as impacted in patients' experiences. Symptoms like insomnia, pain, and fatigue were frequently reported. Symptoms such as fatigue, pain, and financial difficulty explain QoL variance. No significant differences in QoL were found according to the different forms of treatment. Analysis of the interviews revealed three overarching themes: (1) disruption of daily life, (2) adaptation to life with sarcoma, and (3) the demand for more personalized care, allowing to gain a deeper understanding of living with sarcoma. CONCLUSION: The results underscore the significance of delivering care that enhances the quality of life for sarcoma patients, addressing both their physical and psychosocial needs, and providing personalized support throughout all stages of the disease.

Educational intervention about airway obstructions for early childhood teachers: a quasi-experimental study.

OBJECTIVE: To verify the effect of an educational intervention about airway obstructions and an airway clearing technique in teachers from Municipal Child Education Centers in a municipality in western Paraná. METHOD: A quasi-experimental pre- and post-test study. Data was collectedusing a questionnaire with thirty questions to assess knowledge about the subject. For the analyses, the chi-square and McNemar tests were used, withanα = 5% of significance. RESULTS: After the training sessions, there was a 16.22% increase in the number of correct answers to the questions dealing with the recognition of the obstruction (<0.0001) and the airway clearance technique (<0.0001). CONCLUSION: The intervention improved the knowledge of early childhood teachers in the municipality regarding the identification of airway obstruction and techniquesairway clearing in school-age children.

Copper-Contaminated Substrate Biosorption by Penicillium sp. Isolated from Kefir Grains.

In this bioremediation study, the fungus Penicillium sp. isolated from kefir grains was evaluated for its resistance to copper in the culture medium. Penicillium sp. was cultivated in liquid medium prepared using 2% malt-agar at pH 7.0. Biomass of the fungus was significantly reduced, but only when 800 mg·L-1 of Cu(NO3)2 copper nitrate was used. The effect on radial growth of the fungus in experiments combining different pH values and the inorganic contaminant showed an inhibition of 73% at pH 4.0, 75% at pH 7.0 and 77% at pH 9.0 in liquid medium. Thus, even though the growth of Penicillium sp. could be inhibited with relatively high doses of copper nitrate, images obtained with scanning electron microscopy showed the preservation of fungal cell integrity. Therefore, it can be concluded that Penicillium sp. isolated from kefir grains can survive while performing bioremediation to minimize the negative effects of copper on the environment through biosorption.

Educational intervention about airway obstructions for early childhood teachers: a quasi-experimental study / Intervención educativa sobre la obstrucción de las vías respiratorias para profesores de educación de la primera infancia: estudio casi experimental / Intervenção educativa sobre obstrução das vias respiratórias para professores de educação infantil: estudo quase-experimental

ABSTRACT Objective: To verify the effect of an educational intervention about airway obstructions and an airway clearing technique in teachers from Municipal Child Education Centers in a municipality in western Paraná. Method: A quasi-experimental pre- and post-test study. Data was collectedusing a questionnaire with thirty questions to assess knowledge about the subject. For the analyses, the chi-square and McNemar tests were used, withanα = 5% of significance. Results: After the training sessions, there was a 16.22% increase in the number of correct answers to the questions dealing with the recognition of the obstruction (<0.0001) and the airway clearance technique (<0.0001). Conclusion: The intervention improved the knowledge of early childhood teachers in the municipality regarding the identification of airway obstruction and techniquesairway clearing in school-age children.

RESUMEN Objetivo: Verificar el efecto de una intervención educativa sobre la obstrucción de las vías aéreas y una técnica de desobstrucción en docentes de Centros Municipales de Educación Infantil de un municipio del oeste de Paraná. Método: Estudio cuasiexperimental del tipo pre y postest. Se recolectó a los datos a través de un cuestionario con treinta preguntas para evaluar el conocimiento sobre el tema. Para los análisis se utilizaron las pruebas chi-cuadrado y McNemar, con α = 5% de significación. Resultados: Después del entrenamiento, hubo un aumento del 16,22% en el número de respuestas correctas a las preguntas relacionadas con el reconocimiento de la obstrucción (<0,0001) y la técnica de desobstrucción de la vía aérea (<0,0001). Conclusión: La intervención mejoró el conocimiento de los docentes de los centros municipales de educación infantil en cuanto a la identificación y técnica de desobstrucción de las vías respiratorias en niños en edad escolar.

RESUMO Objetivo: Verificar o efeito de uma intervenção educativa sobre a obstrução de vias aéreas e a técnica de desobstrução, em professores de Centros Municipais de Educação Infantil de um município do Oeste do Paraná. Método: Estudo quase-experimental do tipo pré e pós-teste. Os dados foram coletados por meio de um questionário com trinta questões para avaliar o conhecimento sobre a temática. Para as análises utilizou-se os testes de Qui-quadrado e McNemar, com α = 5% de significância. Resultados: Após o treinamento, houve o aumento de 16,22% no número de acertos das questões que tratavam do reconhecimento da obstrução (<0,0001) e da técnica de desobstrução das vias aéreas (<0,0001). Conclusão: A intervenção melhorou o conhecimento dos professores dos Centros Municipais de Educação Infantil, quanto a identificação e a técnica de desobstrução das vias aéreas em crianças de idade escolar.

Risk areas for the occurrence of leprosy in border countries of South America - Brazil and Argentina.

OBJECTIVE: The aim was to analyze the spatial association and relative risk (RR) of leprosy cases diagnosed in southern Brazil and in the Argentinean province of Misiones during 2010 to 2016. METHODS: This ecological-type epidemiological study analyzed data from the Health Ministries of both countries. The analysis included frequency measures, spatial autocorrelation, RR cluster analysis and map construction. RESULTS: A hyperendemic occurrence was identified in all study regions, in the state of Paraná 71.2% of the municipalities were hyperendemic and in Misiones, Argentina 41.2%. The GI* statistical analysis showed clusters of high incidence rates in the state of Paraná and low-risk clusters in much of the state of Rio Grande do Sul, both in Brazil. The analysis indicated an area with RR equal to 3.87 - (p < .0001) when considering the entire territory and an RR of 2.80 - (p < .0001) excluding the state of Paraná, with the number of departments of Misiones, Argentina included in the risk clusters increasing significantly. CONCLUSIONS: The findings indicate a high probability of similar illness in adjacent areas, according to their relative position in space, as the occurrence of the disease is influenced by neighboring clusters.

The genetic mechanisms underlying the convergent evolution of pollination syndromes in the Neotropical radiation of Costus L.

Selection together with variation in floral traits can act to mold floral form, often driven by a plant's predominant or most effective pollinators. To investigate the evolution of traits associated with pollination, we developed a phylogenetic framework for evaluating tempo and mode of pollination shifts across the genus Costus L., known for its evolutionary toggle between traits related to bee and bird pollination. Using a target enrichment approach, we obtained 957 loci for 171 accessions to expand the phylogenetic sampling of Neotropical Costus. In addition, we performed whole genome resequencing for a subset of 20 closely related species with contrasting pollination syndromes. For each of these 20 genomes, a high-quality assembled transcriptome was used as reference for consensus calling of candidate loci hypothesized to be associated with pollination-related traits of interest. To test for the role these candidate genes may play in evolutionary shifts in pollinators, signatures of selection were estimated as dN/dS across the identified candidate loci. We obtained a well-resolved phylogeny for Neotropical Costus despite conflict among gene trees that provide evidence of incomplete lineage sorting and/or reticulation. The overall topology and the network of genome-wide single nucleotide polymorphisms (SNPs) indicate that multiple shifts in pollination strategy have occurred across Costus, while also suggesting the presence of previously undetected signatures of hybridization between distantly related taxa. Traits related to pollination syndromes are strongly correlated and have been gained and lost in concert several times throughout the evolution of the genus. The presence of bract appendages is correlated with two traits associated with defenses against herbivory. Although labellum shape is strongly correlated with overall pollination syndrome, we found no significant impact of labellum shape on diversification rates. Evidence suggests an interplay of pollination success with other selective pressures shaping the evolution of the Costus inflorescence. Although most of the loci used for phylogenetic inference appear to be under purifying selection, many candidate genes associated with functional traits show evidence of being under positive selection. Together these results indicate an interplay of phylogenetic history with adaptive evolution leading to the diversification of pollination-associated traits in Neotropical Costus.

Impactos da pandemia de covid-19 sobre a adesão ao tratamento oncológico: uma revisão integrativa / COVID-19 influence on adherence to oncological treatment: an integrative review / Impactos de la pandemia del COVID-19 en la adherencia al tratamiento oncológico: una revisión integradora

Diversos aspectos influenciam o baixo nível de adesão dos pacientes oncológicos ao tratamento, que é de cerca de 48%. Em um contexto típico, esse número já justifica enormes preocupações, quanto mais durante a pandemia do vírus SARS-CoV-2. O objetivo deste estudo foi identificar como a pandemia de covid-19 influenciou o seguimento terapêutico dos pacientes oncológicos e quais foram as medidas implementadas para garanti-lo. Trata-se de uma revisão de literatura integrativa, na qual se realizou uma procura no PubMed com dois pesquisadores independentes. Dos 161 artigos encontrados, vinte foram incluídos após a aplicação dos critérios de exclusão e análise crítica. Foram identificados em muitos estudos a adesão à telemedicina e o uso de recursos digitais, a testagem sistemática e a triagem de sintomas para covid-19. Além disso, constataram-se medidas de distanciamento social dentro dos centros de saúde, reorganização do espaço comum e alteração na frequência das sessões de quimioterapia. Em um contexto global, o medo e a ansiedade foram relatados pelos pacientes em tratamento. Portanto, identificou-se que inicialmente a pandemia de covid-19 comprometeu a adesão terapêutica, exigindo adequações dos setores de saúde para garantir a segurança dos pacientes oncológicos e permitir o seguimento da terapêutica de forma correta.

Several aspects influence cancer patients' low level of treatment adherence, which is around 48%. In a typical context, this number already warrants huge concern, let alone during the SARS-CoV-2 virus pandemic. Hence, this integrative literature review sought to identify how the COVID-19 pandemic influenced the therapeutic follow-up of cancer patients and which measures were implemented to ensure it. Bibliographic search was conducted by two independent researchers on the PubMed database. Of the 161 articles identified, twenty were included after applying the exclusion criteria and critical analysis. Many studies observed adherence to telemedicine and digital resources, systematic testing and symptom screening for COVID-19. Moreover, social distancing measures within health centers, reorganization of common spaces, and changes in the frequency of chemotherapy sessions were also noted. Overall, patients undergoing treatment reported experiencing fear and anxiety. Thus, the COVID-19 pandemic initially compromised treatment adherence, requiring adjustments in health services to ensure patient safety and allow the correct follow-up of therapy.

Varios aspectos influyen en el bajo nivel de adherencia al tratamiento de los pacientes oncológicos, que llega a casi el 48%. En un contexto típico, este número ya genera grandes preocupaciones, y mucho más durante la pandemia del virus SARS-CoV-2. El objetivo de este estudio fue identificar cómo influyó la pandemia del COVID-19 en el tratamiento de los pacientes oncológicos y qué medidas se implementaron para garantizarlo. Se trata de una revisión integradora de la literatura, en la que se realizó una búsqueda en PubMed, con dos investigadores independientes. De los 161 artículos encontrados, 20 fueron incluidos después de aplicar los criterios de exclusión y análisis crítico. En muchos estudios se observaron la adherencia a la telemedicina y los recursos digitales, las pruebas sistemáticas y la detección de síntomas del COVID-19. Además, se constataron medidas de distancia social dentro de los centros de salud, reorganización de espacios comunes y cambios en la frecuencia de las sesiones de quimioterapia. El miedo y la ansiedad fueron relatados por los pacientes en tratamiento. Así, se identificó que inicialmente la pandemia del COVID-19 comprometió el tratamiento, requiriendo ajustes en los sectores de salud para garantizar la seguridad de los pacientes oncológicos y permitir el seguimiento de la terapia adecuada.

Production, concentration and partial characterization of an enzymatic extract produced by an Aspergillus niger mutant in solid state fermentation.

An enzymatic extract from Aspergillus niger 3T5B8 was produced by Solid State Fermentation (SSF) in aerated columns, using wheat bran as substrate. A combination of extracts produced using three different process conditions varying temperature, pH and aeration formed the final extract (Mixture). The Mixture was concentrated by an ultrafiltration process that partially purified and provided an efficient recovery of the enzymatic activities of xylanase (88.89%), polygalacturonase (89.3%), ß-glucosidase (93.15%), protease (98.68%) and carboxymethylcellulase (CMCase) (98.93%). SDS-PAGE analysis showed 15 visible protein bands in the crude and concentrated Mixture with molecular weights ranging from 15.1 to 104.6 kDa. Thin layer chromatography confirmed the effective action of ß-glucosidase and xylanase hydrolysis activities over cellobiose and xylan, respectively. A central composite design (CCD) with two variables and four replicates at the center points was used to determine the optimal temperature and pH for CMCase and ß-glucosidase. The optimal temperature was 78.9 °C and pH 3.8 for CMCase and 52.8 °C and pH 4.8 for ß-glucosidase, respectively.

Factors related to tissue complications resulting from insulin therapy: a cross-sectional study.

OBJECTIVE: To identify factors related to tissue complications resulting from insulin therapy. METHOD: This is a descriptive, cross-sectional study carried out in a capital of northeastern Brazil. A semi-structured form and an observation guide were applied to assess the performance of insulin preparation and administration techniques. Descriptive statistics, association test, and multivariate logistic regression were used for data analysis. RESULTS: Most participants were female (74.2%), aged between 51 and 70 years (50.0%), and had nine to eleven years of education (36.7%). The presence of some type of local complication in 73.5% of the participants and the failure to rotate the injection sites in 82.3% are highlighted. Being single/widowed and not rotating insulin application sites were related to local complications and increased the chances of their occurrence by 3.51 and 6.70 times, respectively. CONCLUSION: Marital status and nonrotation of injection site were related to the increased chances of tissue complications resulting from insulin therapy.

Respostas adaptativas de colostomizados antes e após o uso do oclusor / Respuestas adaptativas de personas con colostomías antes y después del uso de obturador / Adaptive responses of colostomy patients before and after using an occlude

Resumo Objetivo Compreender as respostas adaptativas de colostomizados antes e após o uso do oclusor. Métodos Estudo qualitativo com 19 indivíduos colostomizados que atendiam a critérios de indicação do oclusor. Os dados coletados foram por meio de duas entrevistas em momentos distintos, analisados pelo software IRaMuTeQ procedendo análise de conteúdo temático sob o prisma do Modelo de Adaptação de Calista Roy. Resultados Antes da utilização do oclusor, os colostomizados sentiam-se constrangidos, a bolsa coletora desencadeou mudanças nas atividades diárias, nutrição e o receio de vazamentos proporcionou vergonha, isolamento e redução das atividades religiosas. Após o uso do oclusor, houve uma nova expectativa de viver, do interagir. As mudanças ocorreram no resgate no comportamento positivo em atividades diárias, como forma de vestir, repouso e à satisfação de retomar atividades que eram realizadas antes da colostomia. Conclusão Constatou-se que as respostas eram ineficazes antes do uso e eficazes após o uso do oclusor.

Resumen Objetivo Entender las respuestas adaptativas de personas con colostomías antes y después del uso de obturador. Métodos Estudio cualitativo con 19 individuos con colostomía que atendían criterios de indicación de obturador. Los datos fueron recopilados por medio de dos entrevistas en distintos momentos, fueron analizados por el software IRaMuTeQ y luego se realizó análisis del contenido temático bajo el prisma del Modelo de Adaptación de Calista Roy. Resultados Antes de la utilización del obturador, las personas con colostomías se sentían avergonzadas, la bolsa colectora desencadenó cambios en las actividades diarias, nutrición y el temor de escapes ocasionó vergüenza, aislamiento y reducción de las actividades religiosas. Después del uso del obturador, hubo una nueva expectativa de vivir, de interactuar. Los cambios se vieron en el rescate del comportamiento positivo en actividades diarias, como forma de vestir, reposo y el placer al retomar actividades que realizaban antes de la colostomía. Conclusión Se constató que las respuestas eran ineficaces antes del uso del obturador, y eficaces después.

Abstract Objective To understand the adaptive responses of colostomy patients before and after using an occluder. Methods This is a qualitative study with 19 colostomy patients who met the criteria for occluder recommendation. Data collected were through two interviews at different times, analyzed by the IRaMuTeQ software, proceeding with thematic content analysis from the perspective of Calilsta Roy's Adaptation Model. Results Before the use of an occluder, colostomy patients felt embarrassed, the collection bag triggered changes in daily activities, nutrition and the fear of leaks provided shame, isolation and reduction of religious activities. After using an occluder, there was a new expectation of living, of interacting. The changes occurred in the rescue of positive behavior in daily activities, such as dressing, rest and the satisfaction of resuming activities that were performed before colostomy. Conclusion It was found that the responses were ineffective before use and effective after using an occluder.

Vigilância do câncer de mama: práticas identificadas pelos gerentes na Atenção Primária / Control del cáncer de mama: prácticas identificadas por los gerentes de la Atención Primaria / Breast cancer surveillance: practices identified by managers in Primary Care

Resumo Objetivo Analisar as práticas no controle do câncer de mama identificadas pelos gerentes da Atenção Primária à Saúde. Métodos Estudo descritivo, transversal, realizado com 24 gerentes de Unidades de Saúde na Atenção Primária, de diferentes configurações (tradicionais, Estratégia de Saúde da Família e Unidades Básicas de Saúde com equipes de Saúde da Família) e contemplando unidades de pequeno, médio e grande porte, localizadas em um município do interior paulista. Foi utilizado um instrumento para identificar ações de rastreamento e detecção de neoplasias mamárias, com 32 questões e subitens, segundo as ações determinadas pelo programa de controle de câncer de mama no Brasil. A análise foi baseada nos atributos de estrutura e processo do Modelo Donabediano. Resultados Com relação às ações de controle de neoplasias mamárias, todos os gerentes, 24 (100%), afirmaram estabelecer prioridade no encaminhamento de mulheres com mamografia e Exame Clínico das Mamas alterados, e solicitação de mamografia para mulheres do grupo de alto risco. Quanto aos entraves na execução dessas ações, a maioria,13 (54,2%), dos gerentes apontaram dificuldades enfrentadas pelos serviços com predomínio de falta de profissionais de saúde e demanda excessiva. Conclusão As Unidades de Saúde da Atenção Primária têm realizado ações para o controle do câncer de mama, mas existem condutas que não estão em conformidades com as propostas do Ministério da Saúde. Existe a necessidade de maior implantação de ações educativas, pois o enfoque é curativo. Também, são necessários maiores investimentos para incrementar as medidas preventivas e potencializar o acesso aos exames de rastreio.

Resumen Objetivo Analizar las prácticas del control del cáncer de mama identificadas por los gerentes de la Atención Primaria de Salud. Métodos Estudio descriptivo, transversal, realizado con 24 gerentes de Unidades de Salud en la Atención Primaria, de diferente configuración (tradicionales, Estrategia Salud de la Familia y Unidades Básicas de Salud con equipos de Salud de la Familia) y tamaño (unidades de pequeño, mediano y gran porte), localizadas en un municipio del interior del estado de São Paulo. Se utilizó un instrumento para identificar acciones de rastreo y detección de neoplasias mamarias, con 32 preguntas y subítems, según las acciones determinadas por el programa de control del cáncer de mama en Brasil. El análisis se basó en los atributos de estructura y proceso del modelo de Donabedian. Resultados Con relación a las acciones de control de neoplasias mamarias, todos los gerentes, 24 (100 %), afirmaron que establecen prioridad en la derivación de mujeres con mamografía y examen clínico de las mamas alterado, y la solicitud de mamografía para mujeres del grupo de alto riesgo. Respecto a los obstáculos para ejecutar estas acciones, la mayoría de los gerentes, 13 (54,2 %), señaló las dificultades enfrentadas por los servicios, con predominio de falta de profesionales de la salud y demanda excesiva. Conclusión Las Unidades de Salud de la Atención Primaria realizan acciones para el control del cáncer de mama, pero existen conductas que no están en conformidad con las propuestas del Ministerio de Salud. Existe una necesidad de mayor implementación de acciones educativas, ya que el enfoque es curativo. También son necesarias mayores inversiones para incrementar las medidas preventivas y potencializar el acceso a los estudios de rastreo.

Abstract Objective To analyze the breast cancer management practices identified by Primary Health Care managers. Methods This is a descriptive, cross-sectional study, carried out with 24 Health Units managers in Primary Care, of different configurations (traditional, Family Health Strategy and Basic Health Units with Family Health teams) and contemplating small, medium and large units, located in a city in the countryside of São Paulo. An instrument was used to identify screening and detection actions for breast cancer, with 32 questions and sub-items, according to the actions determined by the breast cancer management program in Brazil. The analysis was based on Donabedian Model's structure and process attributes. Results With regard to breast cancer management actions, all managers, 24 (100%), stated that they established priority in referring women with altered mammography and Clinical Breast Examination, and requesting mammography for women in the high-risk group. As for obstacles in the execution of these actions, most, 13 (54.2%), managers pointed out difficulties faced by the services, with a predominance of lack of health professionals and excessive demand. Conclusion The Primary Care Health Units have carried out actions to manage breast cancer, but there are behaviors that do not comply with the Ministry of Health's proposals. There is a need for greater implementation of educational actions, as the focus is curative. Also, greater investments are needed to increase preventive measures and enhance access to screening tests.

Factors related to tissue complications resulting from insulin therapy: a cross-sectional study / Factores relacionados con las complicaciones tisulares derivadas de la terapia con insulina: estudio transversal / Fatores relacionados a complicações teciduais decorrentes da insulinoterapia: estudo transversal

Abstract Objective: To identify factors related to tissue complications resulting from insulin therapy. Method: This is a descriptive, cross-sectional study carried out in a capital of northeastern Brazil. A semi-structured form and an observation guide were applied to assess the performance of insulin preparation and administration techniques. Descriptive statistics, association test, and multivariate logistic regression were used for data analysis. Results: Most participants were female (74.2%), aged between 51 and 70 years (50.0%), and had nine to eleven years of education (36.7%). The presence of some type of local complication in 73.5% of the participants and the failure to rotate the injection sites in 82.3% are highlighted. Being single/widowed and not rotating insulin application sites were related to local complications and increased the chances of their occurrence by 3.51 and 6.70 times, respectively. Conclusion: Marital status and nonrotation of injection site were related to the increased chances of tissue complications resulting from insulin therapy.

RESUMEN Objetivo: Identificar factores relacionados con la aparición de complicaciones tisulares resultantes de la terapia con insulina. Método: Estudio descriptivo, transversal, realizado en la capital del noreste de Brasil. Se aplicó un formulario semiestructurado y un guión de observación para evaluar el desempeño de las técnicas de preparación y administración de insulina. Para el análisis de los datos se utilizó estadística descriptiva, prueba de asociación y regresión logística multivariante. Resultados: La mayoría de los participantes eran mujeres (74,2%), con edades comprendidas entre 51 y 70 años (50,0%) y con nueve a once años de escolaridad (36,7%). Se destaca la presencia de algún tipo de complicación local en el 73,5% de los participantes y mala rotación de los sitios de inyección en el 82,3%. Ser soltero/viudo y no rotar los sitios de aplicación de insulina se relacionaron con complicaciones locales y aumentaron la posibilidade de su ocurrencia en 3,51 y 6,70 veces, respectivamente. Conclusión: Se demostró que el estado civil y la mala rotación de los sitios de aplicación estaban relacionados con el aumento de las posibilidades de complicaciones tisulares como resultado de la terapia con insulina.

RESUMO Objetivo: Identificar os fatores relacionados à ocorrência de complicações teciduais decorrentes da insulinoterapia. Método: Estudo descritivo, transversal, realizado em capital do nordeste brasileiro. Aplicaram-se formulário semiestruturado e roteiro de observação para avaliação do desempenho das técnicas de preparo e administração de insulina. Estatística descritiva, teste de associação e regressão logística multivariada foram utilizadas para análise dos dados. Resultados: A maioria dos participantes era do sexo feminino (74,2%), com idades entre 51 e 70 anos (50,0%), e nove a onze anos de estudo (36,7%). Destaca-se a presença de algum tipo de complicação local em 73,5% dos participantes e a não realização do rodízio dos locais de injeção em 82,3%. Estar solteiro/viúvo e não realizar rodízio dos locais de aplicação da insulina relacionaram-se às complicações locais e aumentaram as chances de ocorrência destas em 3,51 e 6,70 vezes, respectivamente. Conclusão: O estado civil e a não realização de rodízio dos locais de aplicação mostraram-se relacionados ao aumento das chances de complicações teciduais decorrentes da insulinoterapia.

Knowledge of primary care nurses before and after educational intervention on diabetic foot.

OBJECTIVE: To compare the knowledge of the nurses about the diabetic foot before and after the educational intervention. METHOD: Quasi-experimental study, before-and-after type, carried out with 53 nurses, from March to June 2016, in the municipality of Campina Grande, Paraíba. The Questioning Methodology was used to develop the educational intervention. Knowledge was investigated using an instrument designed by the researchers. For data analysis before and after the intervention, the McNemar and Wilcoxon tests were performed. RESULTS: The knowledge of the nurses about the diabetic foot turned out to be deficient, with a mean of correct answers in the pre-test of 23.8 (SD±12.8) and after 41.9 (SD±9,2), with a statistically significant difference (p<0.01). CONCLUSION: It was verified a significant increase in the knowledge after the intervention, highlighting the items related to evaluate the loss of plantar protective sensitivity, essential for the prevention of diabetic foot.

Evolution of anthropometric data and quality of life in active bariatric individuals.

OBJECTIVE: Obesity is a disease characterized by the accumulation of abnormal or excessive fat that can damage health. Bariatric surgery, an effective and safe way to treat this disease, requires multidisciplinary monitoring with an educational nature to change lifestyle. Adherence to routine physical activity can be a part of adopting a healthier lifestyle and can assist in the treatment of this disease and its related comorbidities. Thus, the aim of this study was to analyze the correlation between the evolution of anthropometric variables and the domains of quality of life at different times, including at one year after bariatric surgery in very active and irregularly active individuals. METHODS: This was a longitudinal, observational, prospective, and analytical study. The collected data included anamnesis, level of physical activity (International Physical Activity Questionnaire Short Form), height, weight, body mass index (BMI), average waist circumference, percentage of fat, and the World Health Organization Quality of Life Assessment Bref. RESULTS: Seven female individuals were evaluated and divided into two groups: a very active group and an irregularly active group. In the very active individuals, significant results were found in the evolutionary variables: weight (p<0.001); body mass index (p<0.001); average waist circumference (p<0.001); percentage of fat (p<0.001); and quality of life general (p=0.001). In the irregularly active individuals, a significant result was found only in one evolutionary variable: body mass index (p<0.001). CONCLUSION: Thus, it is evident that the improvement and maintenance of good health is more effective in bariatric individuals who maintain a routine with regular physical activity.

Transcriptome Analysis of Melocactus glaucescens (Cactaceae) Reveals Metabolic Changes During in vitro Shoot Organogenesis Induction.

Melocactus glaucescens is an endangered cactus highly valued for its ornamental properties. In vitro shoot production of this species provides a sustainable alternative to overharvesting from the wild; however, its propagation could be improved if the genetic regulation underlying its developmental processes were known. The present study generated de novo transcriptome data, describing in vitro shoot organogenesis induction in M. glaucescens. Total RNA was extracted from explants before (control) and after shoot organogenesis induction (treated). A total of 14,478 unigenes (average length, 520 bases) were obtained using Illumina HiSeq 3000 (Illumina Inc., San Diego, CA, USA) sequencing and transcriptome assembly. Filtering for differential expression yielded 2,058 unigenes. Pairwise comparison of treated vs. control genes revealed that 1,241 (60.3%) unigenes exhibited no significant change, 226 (11%) were downregulated, and 591 (28.7%) were upregulated. Based on database analysis, more transcription factor families and unigenes appeared to be upregulated in the treated samples than in controls. Expression of WOUND INDUCED DEDIFFERENTIATION 1 (WIND1) and CALMODULIN (CaM) genes, both of which were upregulated in treated samples, was further validated by real-time quantitative PCR (RT-qPCR). Differences in gene expression patterns between control and treated samples indicate substantial changes in the primary and secondary metabolism of M. glaucescens after the induction of shoot organogenesis. These results help to clarify the molecular genetics and functional genomic aspects underlying propagation in the Cactaceae family.

Psychological intervention with victims of prison violence: a systematic literature review / Intervención con víctimas de violencia penitenciaria: revisión sistemática de la literatura

BACKGROUND: Prison victimization has been a focus of attention by the scientific community with studies that indicate a high prevalence and negative effects on mental health and social reintegration of prisoners. However, there is few information on intervention responses, so it is relevant to obtain reliable data about intervention strategies that seeks to mitigate its consequences and provide support to victims. OBJECTIVE: accomplish a detailed description of the literature on psychological intervention that seeks to respond to victimization in prison and its consequences. METHOD: Systematic review (SR) using the PRISMA-P method. The research was carried out in 10 electronic databases and the data collection and analysis process carried out by two independent researchers. RESULTS: Five publications were included, three quantitative studies and two theoretical articles although none specifically focuses on intervention with individuals subject to prison victimization. This feature is addressed and theoretically analyzed throughout the discussion. CONCLUSION: There are few publications on intervention with victims of pris-on victimization and existing ones do not focus on specific intervention in the context of this type of victimization. However, important guidelines were obtained to be included into future intervention proposals. There is a consensus regarding the need to adopt empirically validated intervention models, referring to the Cognitive Behavior Therapy (CBT), specifically to the Trauma-Informed Treatment (TIT)

INTRODUCCIÓN: La victimización penitenciaria ha sido el foco de atención de la comunidad científica con estudios que indican una alta prevalencia y efectos negativos en la salud mental y en la reintegración social de los presidiarios. Sin embargo, existe poca información sobre las intervenciones, por lo que es relevante obtener datos confiables sobre estrategias de intervención que busquen mitigar sus consecuencias y ofrecer apoyo a las víctimas. OBJETIVO: realizar una descripción detallada de la literatura sobre intervención psicológica que busca dar respuesta a la victimización en prisión y sus consecuencias. MÉTODO: Revisión sistemática (RS) mediante el método PRISMA-P. La investigación se realizó en 10 bases de datos electrónicas y el proceso de recolección y análisis de datos fue realizado por dos investigadores independientes. RESULTADOS: Se incluyeron cinco publicaciones, tres estudios cuantitativos y dos artículos teóricos, aunque ninguno se centra específicamente en la intervención con personas sometidas a victimización penitenciaria. Este as-pecto se aborda y analiza teóricamente a lo largo de la discusión. CONCLUSIÓN: Existen pocas publicaciones sobre intervención con personas victimizadas en prisión y las existentes no enfocan en detalle en la intervención en este tipo de victimización. Sin embargo, se obtuvieron datos relevantes para ser incluidos en futuras propuestas de intervención. Existe consenso en cuanto a la necesidad de adoptar modelos de intervención valida-dos empíricamente, refiriéndose a la Terapia Cognitivo Conductual (TCC), específicamente al Tratamiento Informado por Trauma (TIT)

Evolution of anthropometric data and quality of life in active bariatric individuals

SUMMARY Obesity is a disease characterized by the accumulation of abnormal or excessive fat that can damage health. Bariatric surgery, an effective and safe way to treat this disease, requires multidisciplinary monitoring with an educational nature to change lifestyle. Adherence to routine physical activity can be a part of adopting a healthier lifestyle and can assist in the treatment of this disease and its related comorbidities. OBJECTIVE: Thus, the aim of this study was to analyze the correlation between the evolution of anthropometric variables and the domains of quality of life at different times, including at one year after bariatric surgery in very active and irregularly active individuals. METHODS: This was a longitudinal, observational, prospective, and analytical study. The collected data included anamnesis, level of physical activity (International Physical Activity Questionnaire Short Form), height, weight, body mass index (BMI), average waist circumference, percentage of fat, and the World Health Organization Quality of Life Assessment Bref. RESULTS: Seven female individuals were evaluated and divided into two groups: a very active group and an irregularly active group. In the very active individuals, significant results were found in the evolutionary variables: weight (p<0.001); body mass index (p<0.001); average waist circumference (p<0.001); percentage of fat (p<0.001); and quality of life general (p=0.001). In the irregularly active individuals, a significant result was found only in one evolutionary variable: body mass index (p<0.001). CONCLUSION: Thus, it is evident that the improvement and maintenance of good health is more effective in bariatric individuals who maintain a routine with regular physical activity.

Pilosocereus gounellei (Cactaceae) stem extract decreases insulin resistance, inflammation, oxidative stress, and cardio-metabolic risk in diet-induced obese mice.

ETHNOPHARMACOLOGICAL RELEVANCE: Pilosocereus gounellei (xique-xique) is a popular cactus from Caatinga, traditionally used to counter inflammatory processes and indicated as a hypoglycemic agent. Previous studies have shown that mice treated orally with saline extract of P. gounellei stem (containing flavonoids and sugars) showed decreased serum lipid levels. AIM OF THE STUDY: In this work, we evaluated whether this extract would have beneficial effects against hyperglycemia and inflammatory status related to obesity in mice fed a high-fat diet (HFD). METHODS: Obese animals were treated daily per os with the extract (EXT; 125, 250, and 500 mg/kg), metformin (MET; 400 mg/kg), or saline solution (diet-induced obese, DIO) for 21 days. A group of non-obese animals served as the control. We evaluated lipid profile, glucose and insulin tolerance, atherogenic indices, histological alterations, cytokine levels, and oxidative stress in liver, muscle, and adipose tissue. RESULTS: At the end of the experiment, mice from EXT groups showed lower body weight and total cholesterol, LDL-cholesterol, and triglycerides compared with the DIO group; in addition, HDL-cholesterol levels and glucose and insulin tolerance were similar to those of the control group. When compared with the DIO group, the extract-treated mice showed reduction in cardiac risk ratio, atherogenic coefficient, atherogenic index of plasma, and Castelli's Risk Index II; decrease in epididymal fat; reduction in steatosis, collagen deposition, and liver inflammation; lower serum levels of pro-inflammatory cytokines (tumor necrosis factor α, interleukin 6, and monocyte chemoattractant protein-1); inhibited lipid peroxidation; and increased superoxide dismutase levels in liver, muscle, and adipose tissue. CONCLUSION: The P. gounellei saline extract was able to improve physiological parameters of obese mice, which highlight the potential of this plant as source of compounds with biotechnological relevance for pharmaceutical industry.

Knowledge of primary care nurses before and after educational intervention on diabetic foot / Conocimiento de las enfermeras de atención primaria antes y después de la intervención educativa acerca del pie diabético / Conhecimento de enfermeiros da atenção primária antes e após intervenção educativa sobre pé diabético

ABSTRACT Objective: To compare the knowledge of the nurses about the diabetic foot before and after the educational intervention. Method: Quasi-experimental study, before-and-after type, carried out with 53 nurses, from March to June 2016, in the municipality of Campina Grande, Paraíba. The Questioning Methodology was used to develop the educational intervention. Knowledge was investigated using an instrument designed by the researchers. For data analysis before and after the intervention, the McNemar and Wilcoxon tests were performed. Results: The knowledge of the nurses about the diabetic foot turned out to be deficient, with a mean of correct answers in the pre-test of 23.8 (SD±12.8) and after 41.9 (SD±9,2), with a statistically significant difference (p<0.01). Conclusion: It was verified a significant increase in the knowledge after the intervention, highlighting the items related to evaluate the loss of plantar protective sensitivity, essential for the prevention of diabetic foot.

RESUMEN Objetivo: Comparar los conocimientos de las enfermeras sobre el pie diabético antes y después de la intervención educativa. Método: Estudio cuasi experimental, tipo antes y después, realizado con 53 enfermeros, de marzo a junio de 2016, en el municipio de Campina Grande, Paraíba. Se utilizó la Metodología del Cuestionamiento para desarrollar la intervención educativa. El conocimiento fue investigado mediante un instrumento diseñado por los investigadores. Para el análisis de datos antes y después de la intervención, se realizaron las pruebas de McNemar y Wilcoxon. Resultados: El conocimiento de las enfermeras sobre el pie diabético resultó ser deficiente, con un promedio de aciertos en el pre-test de 23,8 (DE±12,8) y posterior a 41,9 (DE±9,2), con diferencia estadísticamente significativa (p<0,01). Conclusión: Hubo un aumento significativo en el conocimiento luego de la intervención, destacando las pruebas para evaluar la pérdida de sensibilidad protectora del pie, fundamentales para la prevención del pie diabético.

RESUMO Objetivo: Comparar o conhecimento de enfermeiros sobre o pé diabético antes e após intervenção educativa. Método: Estudo quase experimental, do tipo antes e depois, realizado com 53 enfermeiros, de março a junho de 2016, no município de Campina Grande, Paraíba. Foi utilizada a Metodologia da Problematização para o desenvolvimento da intervenção educativa. O conhecimento foi investigado por meio de um instrumento delineado pelas pesquisadoras. Para análise dos dados antes e após intervenção, realizaram-se os testes de McNemar e de Wilcoxon. Resultados: O conhecimento dos enfermeiros sobre pé diabético mostrou-se deficiente, com média de acertos no pré-teste de 23,8 (DP±12,8) e após 41,9 (DP±9,2), com diferença estatisticamente significativo (p<0,01). Conclusão: Verificou-se aumento significativo do conhecimento após a intervenção, destacando-se os itens relacionados à avaliação da perda de sensibilidade protetora plantar, fundamentais à prevenção do pé diabético.

Validação de instrumento para investigação do conhecimento de enfermeiros sobre pé diabético / Validación del instrumento para la investigación del conocimiento de enfermeros sobre pie diabético / Validation of an instrument to investigate nurses' knowledge on diabetic foot

RESUMO Objetivo: construir e validar um instrumento para investigação do conhecimento de enfermeiros da Atenção Primária à Saúde sobre pé diabético. Método: estudo metodológico realizado de janeiro a junho de 2017, que seguiu o Modelo de Elaboração de Escalas Psicométricas de Pasquali, em três etapas: teórica, empírica e analítica. Para validação de conteúdo, adotou-sea técnica de Delphi em dois momentos, com a participação de 10 juízes. A validade de construto foi realizada por 73 enfermeiros que atuavam nos serviços de APS do município de Campina Grande-PB. Aos dados, aplicou-se o Índice de Validação de Conteúdo (IVC). Resultados: construiu-se o "Questionário de Investigação do Conhecimento do Enfermeiro sobre Pé Diabético (QICEPeD)" com 47 itens organizados em 12 domínios de conhecimentos sobre a temática. Após a segunda rodada de avaliação dos juízes, todos os itens atingiram escores máximos de concordância (IVC = 1,00). A análise da confiabilidade e da consistência interna total do instrumento foi considerada elevada (α=0,860). Conclusão: o instrumento QICEPeD foi considerado válido, quanto ao conteúdo e construto, podendo ser utilizado para avaliar o conhecimento de enfermeiros da Atenção Primária sobre pé diabético.

RESUMEN Objetivo: construir y validar un instrumento para la investigación del conocimiento de enfermeros de la Atención Primaria de la Salud (APS) sobre pie diabético. Método: estudio metodológico realizado de enero a junio de 2017, que siguió el Modelo de Elaboración de Propiedades Psicométricas de Pasquali, en tres etapas: teórica, empírica y analítica. Para la validación de contenido, se adoptó el método de Delphi en dos momentos, con la participación de 10 jueces. La validez del constructo fue realizada por 73 enfermeros que actuaban en los servicios de APS del municipio de Campina Grande-PB-Brasil. Para los datos, se aplicó el Índice de Validez de Contenido (IVC). Resultados: se construyó el "Cuestionario de Investigación del Conocimiento del Enfermero sobre Pie Diabético (CICEPeD)" con 47 ítems organizados en 12 dominios de conocimientos sobre la temática. Después de la segunda ronda de evaluación de los jueces, todos los elementos alcanzaron puntajes máximos de concordancia (IVC=1,00). El análisis de la confiabilidad y de la consistencia interna total del instrumento fue considerado alto (α=0,860). Conclusión: el instrumento CICEPeD fue considerado válido, en cuanto al contenido y constructo, pudiendo ser utilizado para evaluar el conocimiento de enfermeros de la Atención Primaria sobre pie diabético

ABSTRACT Objective: to construct and validate an instrument to investigate the knowledge of Primary Health Care nurseson diabetic foot. Method: methodological study carried out from January to June 2017, followed the Development Model for Psychometric Scales by Pasquali, in three stages: theoretical, empirical and analytical. In order to validate the content, the Delphi technique was adopted in two moments, with the participation of 10 judges. Construct validity was performed by 73 nurses who worked in PHC services in the municipality of Campina Grande-PB. The Content Validation Index (CVI) was applied to the data. Results: the "Questionnaire for Investigating Nurses' Knowledge on Diabetic Foot (QICEPeD, as per its Portuguese acronym)" was constructed with 47 elements organized into 12 domains of knowledge on the topic. After the second round of judges' assessment, all elements reached maximum agreement scores (CVI = 1.00). The analysis of the instrument's reliability and total internal consistency was considered high (α=0.860). Conclusion: the QICEPeD instrument was considered valid, in terms of content and construct, and can be used to assess the level of knowledge of Primary Care nurses on diabetic foot.