ASSOCIAÇÕES ENTRE TRANSTORNOS ALIMENTARES E A OBESIDADE

Introduction: This study aims to investigate and analyze the complex behavioral relationships between eating disorders and obesity by evaluating the therapeutic interventions recently explored in the scientific literature. Methods: An integrative literature review focused on clinical trials published in the last five years, accessed through the PubMed database, using selected descriptors. Results: After analyzing the articles found, following predefined inclusion and exclusion criteria, 11 studies were identified that applied behavioral interventions to individuals facing the complex interaction between obesity and eating disorders. The interventions examined were Behavioral Weight Loss (BWL), the Healthy Approach to Weight Management and Food in Eating Disorders (HAPIFED), and Treatments Based on Acceptance and Commitment Therapy. In addition, Standard Cognitive Behavioral Therapy was also evaluated in some studies. Effectiveness varied between studies, with some interventions showing significant benefits and others showing no significant differences compared to control groups. Conclusion: This review highlights the growing importance of behavioral therapeutic approaches in the management of obese individuals with eating disorders. However, it highlights the need for more in-depth future research to determine the effectiveness of these interventions and to offer more precise and personalized guidelines for the treatment of this complex relationship between obesity and eating disorders.Introducción: Este estudio tiene como objetivo investigar y analizar las complejas relaciones conductuales entre los trastornos alimentarios y la obesidad, a través de la evaluación de intervenciones terapéuticas recientemente exploradas en la literatura científica. Métodos: Se realizó una revisión integradora de la literatura centrada en los ensayos clínicos publicados en los últimos cinco años, a los que se accedió a través de la base de datos PubMed, utilizando descriptores seleccionados. Resultados: Después de analizar los artículos encontrados, siguiendo criterios de inclusión y exclusión predefinidos, se identificaron 11 estudios que aplicaron intervenciones conductuales en individuos que enfrentan la compleja interacción entre obesidad y trastornos alimentarios. Entre las intervenciones examinadas se encuentran la Terapia Cognitivo Conductual para la Internalización del Estigma del Peso (BWL), el Enfoque de Salud para el Control del Peso y la Alimentación en los Trastornos de la Alimentación (HAPIFED) y los Tratamientos Basados en la Terapia de Aceptación y Compromiso. Además, la terapia cognitivo-conductual estándar también se ha evaluado en algunos estudios. La efectividad varió entre los estudios, con algunas intervenciones que mostraron beneficios significativos y otras que no mostraron diferencias significativas con respecto a los grupos control. Conclusión: Los enfoques terapéuticos conductuales son relevantes para el tratamiento de individuos obesos con trastornos alimentarios. Sin embargo, es necesario seguir investigando en el futuro para determinar la eficacia de estas intervenciones, con el fin de proporcionar pautas más precisas y personalizadas para el tratamiento de esta compleja relación entre la obesidad y los trastornos alimentarios. Este estudo tem como objetivo investigar e analisar as complexas relações comportamentais entre transtornos alimentares e obesidade, através da avaliação das intervenções terapêuticas recentemente exploradas na literatura científica. Métodos: Uma revisão integrativa da literatura foi conduzida com foco em ensaios clínicos publicados nos últimos cinco anos, acessados por meio da base de dados PubMed, utilizando descritores selecionados. Resultados: Após análise dos artigos encontrados, seguindo critérios de inclusão e exclusão predefinidos, foram identificados 11 estudos que aplicaram intervenções comportamentais em indivíduos que enfrentam a complexa interação entre obesidade e transtornos alimentares. Entre as intervenções examinadas, destacam-se a Terapia Cognitivo-Comportamental para Internalização do Estigma do Peso (do inglês, Behavioral Weight Loss - BWL), a Abordagem de Saúde para Controle de Peso e Alimentação em Transtornos Alimentares (do inglês, a Healthy Approach to Weight Management and Food in Eating Disorders - HAPIFED) e os Tratamentos Baseados na Terapia de Aceitação e Compromisso. Adicionalmente, a Terapia Cognitivo-Comportamental Padrão também foi avaliada em alguns estudos. A efetividade variou entre os estudos, com algumas intervenções mostrando benefícios significativos e outras não apresentando diferenças significativas em relação aos grupos de controle. Conclusão: As abordagens terapêuticas comportamentais são relevantes para o tratamento de indivíduos portadores de obesidade com transtornos alimentares. No entanto, ressalta-se a necessidade de pesquisas futuras mais aprofundadas para determinar a eficácia dessas intervenções, visando oferecer diretrizes mais precisas e personalizadas para o tratamento dessa complexa relação entre obesidade e transtornos alimentares.Introdução: Este estudo tem como objetivo investigar e analisar as complexas relações comportamentais entre transtornos alimentares e obesidade, através da avaliação das intervenções terapêuticas recentemente exploradas na literatura científica. Métodos: Uma revisão integrativa da literatura foi conduzida com foco em ensaios clínicos publicados nos últimos cinco anos, acessados por meio da base de dados PubMed, utilizando descritores selecionados. Resultados: Após análise dos artigos encontrados, seguindo critérios de inclusão e exclusão predefinidos, foram identificados 11 estudos que aplicaram intervenções comportamentais em indivíduos que enfrentam a complexa interação entre obesidade e transtornos alimentares. Entre as intervenções examinadas, destacam-se a Terapia Cognitivo-Comportamental para Internalização do Estigma do Peso (do inglês, Behavioral Weight Loss - BWL), a Abordagem de Saúde para Controle de Peso e Alimentação em Transtornos Alimentares (do inglês, a Healthy Approach to Weight Management and Food in Eating Disorders - HAPIFED) e os Tratamentos Baseados na Terapia de Aceitação e Compromisso. Adicionalmente, a Terapia Cognitivo-Comportamental Padrão também foi avaliada em alguns estudos. A efetividade variou entre os estudos, com algumas intervenções mostrando benefícios significativos e outras não apresentando diferenças significativas em relação aos grupos de controle. Conclusão: As abordagens terapêuticas comportamentais são relevantes para o tratamento de indivíduos portadores de obesidade com transtornos alimentares. No entanto, ressalta-se a necessidade de pesquisas futuras mais aprofundadas para determinar a eficácia dessas intervenções, visando oferecer diretrizes mais precisas e personalizadas para o tratamento dessa complexa relação entre obesidade e transtornos alimentares

Protocol Proposal For The Care Of The Person With Venous Ulcer

Objective: To propose a care protocol for the care of the person with a venous ulcer in highly complex services. Methods and results: This is a methodological study, in three stages: literature review, validation of content and validation in the clinical context. The literature review was carried out from June to August/2011, being the basis for the construction of the Protocol for Venous Ulcers. The content validation included 53 judges (44 nurses, 8 physicians and 1 physiotherapist) selected through the Lattes platform to evaluate the items of the protocol. Validation in the clinical context occurred at the University Hospital Onofre Lopes, in Natal/RN with four judges (nurses), who worked in pairs, evaluating 32 patients with venous ulcers. The protocol was validated with 15 categories: sociodemographic data; anamnesis; examinations; ulcer characteristics; care with the lesion and perilesional area; medicines used to treat the lesion; evaluation and treatment of pain; surgical treatment of chronic venous disease; recurrence prevention (clinical and educational strategies); reference; counter-reference; and quality of life. Conclusion: The validated protocol regarding content and clinical context was applicable. Its implementation is a viable measure that assists in the reorientation of the team in high complexity services, aiming at wound healing and restoration of the patient´s integral health. Keywords: Varicose ulcer; Tertiary Health Care; Protocols; Validation studies

Evaluation Of The Quality Of Assistance In An Pre-Hospital Mobile Emergency Service

Background: to evaluate the quality of the assistance of a Mobile Emergency Care Service and to compare the evaluation of professionals according to training and level of education. Methods and Findings: this is a cross-sectional study, with a Donabedian theoretical reference. The sample was all the professionals of a Mobile Emergency Service and data collection performed by a previously validated quality assessment instrument. Some aspects of the service structure were evaluated negatively, and the process was evaluated in a positive way, in general. When comparing the evaluation of quality according to professional category and education, it was verified that the indicators of structure and process were considered appropriate by the professionals of average level and inadequate by the personnel of superior level. Conclusion: the professionals identified flaws in the service structure, which can impact the assistance provided. The level of education influenced the evaluation of the quality of the service. Keywords: Emergency medical services; Health Evaluation; Prehospital care; Evaluation studies; Health services &nbsp

Characterization of Publications on Burns in Brazil and Changes Resulting from Trauma in Brazil: Systematic Review of the Literature

Objective: Characterize the profile of scientific publications on burns in Brazil and systemic changes resulting from the trauma. Methods and results: This is a bibliographical, retrospective and descriptive research with a quantitative approach. It was held between April and May, 2016 in the databases Latin American and Caribbean Center on Health Sciences (LILACS); Nursing Database (BDENF); Medical Literature Analysis and Retrieval System Online (MEDLINE), Scientific Electronic Library Online (SciELO) and the Journal Portal of Higher Education Personnel Improvement Coordination (CAPES). After the analysis of the inclusion criteria (articles available in full, in Portuguese, published between 2011 and 2015), there were 49 productions, and 16 were selected. Analyzing the sample for the event characteristics, it was observed a higher incidence of accidents in males. The main causes of burns were heated by liquid, followed by direct flame. Regarding the classification, the most frequent injury was the 2nd degree, but also there were burns reports with mixed classification. Also, the upper limbs and trunk were the body parts most affected. In addition to these data, it was also highlighted the most frequent types of systemic changes caused by burns, which were respiratory complications, infection and/or sepsis and metabolic sequels.  Conclusion: The study showed the need to characterize of the publications in burns, since the crossing of this information provides a better understanding of the main causal factors, distribution and identification of risk groups. It also enables the planning of prevention strategies to help to reduce accidents, favoring the reduction of injuries and the number of hospitalizations. Moreover, it is extremely important that health professionals know about the epidemiological profile, to provide support in the evaluation and organization of care, and to prevention campaigns, aiming to decrease burn rates. Keywords: Profile; Burns; Burn Units

Brazilian Flora 2020: Leveraging the power of a collaborative scientific network

International audienceThe shortage of reliable primary taxonomic data limits the description of biological taxa and the understanding of biodiversity patterns and processes, complicating biogeographical, ecological, and evolutionary studies. This deficit creates a significant taxonomic impediment to biodiversity research and conservation planning. The taxonomic impediment and the biodiversity crisis are widely recognized, highlighting the urgent need for reliable taxonomic data. Over the past decade, numerous countries worldwide have devoted considerable effort to Target 1 of the Global Strategy for Plant Conservation (GSPC), which called for the preparation of a working list of all known plant species by 2010 and an online world Flora by 2020. Brazil is a megadiverse country, home to more of the world's known plant species than any other country. Despite that, Flora Brasiliensis, concluded in 1906, was the last comprehensive treatment of the Brazilian flora. The lack of accurate estimates of the number of species of algae, fungi, and plants occurring in Brazil contributes to the prevailing taxonomic impediment and delays progress towards the GSPC targets. Over the past 12 years, a legion of taxonomists motivated to meet Target 1 of the GSPC, worked together to gather and integrate knowledge on the algal, plant, and fungal diversity of Brazil. Overall, a team of about 980 taxonomists joined efforts in a highly collaborative project that used cybertaxonomy to prepare an updated Flora of Brazil, showing the power of scientific collaboration to reach ambitious goals. This paper presents an overview of the Brazilian Flora 2020 and provides taxonomic and spatial updates on the algae, fungi, and plants found in one of the world's most biodiverse countries. We further identify collection gaps and summarize future goals that extend beyond 2020. Our results show that Brazil is home to 46,975 native species of algae, fungi, and plants, of which 19,669 are endemic to the country. The data compiled to date suggests that the Atlantic Rainforest might be the most diverse Brazilian domain for all plant groups except gymnosperms, which are most diverse in the Amazon. However, scientific knowledge of Brazilian diversity is still unequally distributed, with the Atlantic Rainforest and the Cerrado being the most intensively sampled and studied biomes in the country. In times of “scientific reductionism”, with botanical and mycological sciences suffering pervasive depreciation in recent decades, the first online Flora of Brazil 2020 significantly enhanced the quality and quantity of taxonomic data available for algae, fungi, and plants from Brazil. This project also made all the information freely available online, providing a firm foundation for future research and for the management, conservation, and sustainable use of the Brazilian funga and flora

Erratum to: Guidelines for the use and interpretation of assays for monitoring autophagy (3rd edition) (Autophagy, 12, 1, 1-222, 10.1080/15548627.2015.1100356

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Guidelines for the use and interpretation of assays for monitoring autophagy (4th edition)

In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monitoring autophagy in different organisms. Despite numerous reviews, there continues to be confusion regarding acceptable methods to evaluate autophagy, especially in multicellular eukaryotes. Here, we present a set of guidelines for investigators to select and interpret methods to examine autophagy and related processes, and for reviewers to provide realistic and reasonable critiques of reports that are focused on these processes. These guidelines are not meant to be a dogmatic set of rules, because the appropriateness of any assay largely depends on the question being asked and the system being used. Moreover, no individual assay is perfect for every situation, calling for the use of multiple techniques to properly monitor autophagy in each experimental setting. Finally, several core components of the autophagy machinery have been implicated in distinct autophagic processes (canonical and noncanonical autophagy), implying that genetic approaches to block autophagy should rely on targeting two or more autophagy-related genes that ideally participate in distinct steps of the pathway. Along similar lines, because multiple proteins involved in autophagy also regulate other cellular pathways including apoptosis, not all of them can be used as a specific marker for bona fide autophagic responses. Here, we critically discuss current methods of assessing autophagy and the information they can, or cannot, provide. Our ultimate goal is to encourage intellectual and technical innovation in the field