A randomized controlled trial to evaluate the efficacy of metacognitive training for older adults with depression (MCT-Silver) in Portugal: study protocol

First publication by Frontiers MediaDepression is one of the most common psychological disorders in later life. Although psychological interventions are recommended by treatment guidelines, most older adults with depression remain untreated. The aim of this study is to evaluate the efficacy of the Portuguese version of Metacognitive Training for Depression in later life (MCT-Silver)

A randomized controlled trial to evaluate the efficacy of metacognitive training for older adults with depression (MCT-Silver) in Portugal: study protocol

IntroductionDepression is one of the most common psychological disorders in later life. Although psychological interventions are recommended by treatment guidelines, most older adults with depression remain untreated. The aim of this study is to evaluate the efficacy of the Portuguese version of Metacognitive Training for Depression in later life (MCT-Silver).MethodsThis is a study protocol of an observer-blind, parallel-group, randomized controlled trial to compare the efficacy of MCT-Silver with a treatment as usual (TAU) control group among older adults (age 65 years and older) with depressive symptoms according to the Montgomery-Asberg Depression Scale. Participants will be tested at three assessment time points (baseline, immediately following the intervention [8 weeks], and 3 months after the intervention). The primary outcome is change in self-rated depression symptoms assessed by the Beck Depression Inventory (BDI-II). Secondary outcomes include clinician-rated depression, self-esteem, dysfunctional beliefs, metacognitive beliefs, ruminations, attitudes toward aging and quality of life. A self-designed subjective appraisal rating scale consisting of 21-items will be used to assess participant acceptance of MCT-Silver.DiscussionMCT-Silver is an innovative intervention, which aims to reduce dysfunctional thoughts as well as depression-related behaviors and coping strategies through the metacognitive perspective. Until now, the training has only been tested in Germany. It is expected that after 8 weeks of treatment and 3 months later, the experimental group will demonstrate significant reductions in depressive symptoms, metacognitive beliefs, dysfunctional attitudes and ruminative responses compared to the TAU group. Moreover, quality of life, self-esteem, and attitudes towards aging will be significantly improved in MCT-Silver compared to the TAU group.Clinical trial registrationClinicalTrials.gov, NCT05640492

Conexão de saberes: a extensão da Universidade de Brasília em Ceilândia e as expectativas dos jovens de origem popular

A maioria dos jovens de origem popular passa grande parte da sua vida estudando na rede pública de ensino. No entanto, ao término do Ensino Médio, a maioria não consegue garantir o seu ingresso em universidades públicas, o que demonstra que estes jovens estão em condição de desigualdade. Neste quadro, muitos desistem de entrar na universidade enquanto outros continuam tentando novos vestibulares. Este artigo1 objetiva discutir a situação dos jovens de origem popular da cidade de Ceilândia, DF, alunos do ensino médio e suas expectativas em relação ao Ensino Superior. Esta expectativa é levantada pelos conexistas do Projeto Caminhadas para a Universidade em Ceilândia, utilizando como instrumento metodológico um questionário contendo questões abertas e fechadas. Os resultados demonstram que os investigados, em sua maioria, já prestaram vestibular para adquirir experiência, tendo os cursos de letras, direito e pedagogia como destaque. Conclui-se que a maioria dos jovens tem o objetivo de entrar na universidade pública com o intuito de fazer concurso público e ter um cargo efetivo, enquanto uma minoria busca continuidade nos estudos para se realizar na área escolhida

Effects of Bone Marrow Mesenchymal Stromal Cell Therapy in Experimental Cutaneous Leishmaniasis in BALB/c Mice Induced by Leishmania amazonensis

Cutaneous leishmaniasis remains both a public health and a therapeutic challenge. To date, no ideal therapy for cutaneous leishmaniasis has been identified, and no universally accepted therapeutic regimen and approved vaccines are available. Due to the mesenchymal stromal cell (MSC) immunomodulatory capacity, they have been applied in a wide variety of disorders, including infectious, inflammatory, and allergic diseases. We evaluated the potential effects of bone marrow MSC therapy in a murine model of cutaneous leishmaniasis. In vitro, coculture of infected macrophages with MSC increased parasite load on macrophages in comparison with controls (macrophages without MSCs). In vivo, BALB/c mice were infected with 2 × 106Leishmania amazonensis (Josefa strain) promastigotes in the footpad. 7 and 37 days after infection, animals were treated with 1 × 105 MSCs, either intralesional (i.l.), i.e., in the same site of infection, or intravenously (i.v.), through the external jugular vein. Control animals received the same volume (50 µL) of phosphate-buffered saline by i.l. or i.v. routes. The lesion progression was assessed by its thickness measured by pachymetry. Forty-two days after infection, animals were euthanized and parasite burden in the footpad and in the draining lymph nodes was quantified by the limiting dilution assay (LDA), and spleen cells were phenotyped by flow cytometry. No significant difference was observed in lesion progression, regardless of the MSC route of administration. However, animals treated with i.v. MSCs presented a significant increase in parasite load in comparison with controls. On the other hand, no harmful effect due to MSCs i.l. administered was observed. The spleen cellular profile analysis showed an increase of IL-10 producing T CD4+ and TCD8+ cells in the spleen only in mice treated with i.v. MSC. The excessive production of IL-10 could be associated with the disease-aggravating effects of MSC therapy when intravenously administered. As a conclusion, in the current murine model of L. amazonensis-induced cutaneous disease, MSCs did not control the damage of cutaneous disease and, depending on the administration route, it could result in deleterious effects

One More Piece in the VACV Ecological Puzzle: Could Peridomestic Rodents Be the Link between Wildlife and Bovine Vaccinia Outbreaks in Brazil?

BACKGROUND: Despite the fact that smallpox eradication was declared by the World Health Organization (WHO) in 1980, other poxviruses have emerged and re-emerged, with significant public health and economic impacts. Vaccinia virus (VACV), a poxvirus used during the WHO smallpox vaccination campaign, has been involved in zoonotic infections in Brazilian rural areas (Bovine Vaccinia outbreaks - BV), affecting dairy cattle and milkers. Little is known about VACV's natural hosts and its epidemiological and ecological characteristics. Although VACV was isolated and/or serologically detected in Brazilian wild animals, the link between wildlife and farms has not yet been elucidated. METHODOLOGY/PRINCIPAL FINDINGS: In this study, we describe for the first time, to our knowledge, the isolation of a VACV (Mariana virus - MARV) from a mouse during a BV outbreak. Genetic data, in association with biological assays, showed that this isolate was the same etiological agent causing exanthematic lesions observed in the cattle and human inhabitants of a particular BV-affected area. Phylogenetic analysis grouped MARV with other VACV isolated during BV outbreaks. CONCLUSION/SIGNIFICANCE: These data provide new biological and epidemiological information on VACV and lead to an interesting question: could peridomestic rodents be the link between wildlife and BV outbreaks

In situ short-term responses of Amazonian understory plants to elevated CO₂

The response of plants to increasing atmospheric CO2 depends on the ecological context where the plants are found. Several experiments with elevated CO2 (eCO2) have been done worldwide, but the Amazonian forest understory has been neglected. As the central Amazon is limited by light and phosphorus, understanding how understory responds to eCO2 is important for foreseeing how the forest will function in the future. In the understory of a natural forest in the Central Amazon, we installed four open-top chambers as control replicates and another four under eCO2 (+250 ppm above ambient levels). Under eCO2, we observed increases in carbon assimilation rate (67%), maximum electron transport rate (19%), quantum yield (56%), and water use efficiency (78%). We also detected an increase in leaf area (51%) and stem diameter increment (65%). Central Amazon understory responded positively to eCO2 by increasing their ability to capture and use light and the extra primary productivity was allocated to supporting more leaf and conducting tissues. The increment in leaf area while maintaining transpiration rates suggests that the understory will increase its contribution to evapotranspiration. Therefore, this forest might be less resistant in the future to extreme drought, as no reduction in transpiration rates were detected.</p

In situ short-term responses of Amazonian understory plants to elevated CO₂

The response of plants to increasing atmospheric CO2 depends on the ecological context where the plants are found. Several experiments with elevated CO2 (eCO2) have been done worldwide, but the Amazonian forest understory has been neglected. As the central Amazon is limited by light and phosphorus, understanding how understory responds to eCO2 is important for foreseeing how the forest will function in the future. In the understory of a natural forest in the Central Amazon, we installed four open-top chambers as control replicates and another four under eCO2 (+250 ppm above ambient levels). Under eCO2, we observed increases in carbon assimilation rate (67%), maximum electron transport rate (19%), quantum yield (56%), and water use efficiency (78%). We also detected an increase in leaf area (51%) and stem diameter increment (65%). Central Amazon understory responded positively to eCO2 by increasing their ability to capture and use light and the extra primary productivity was allocated to supporting more leaf and conducting tissues. The increment in leaf area while maintaining transpiration rates suggests that the understory will increase its contribution to evapotranspiration. Therefore, this forest might be less resistant in the future to extreme drought, as no reduction in transpiration rates were detected.</p

Virulence in Murine Model Shows the Existence of Two Distinct Populations of Brazilian Vaccinia virus Strains

Brazilian Vaccinia virus had been isolated from sentinel mice, rodents and recently from humans, cows and calves during outbreaks on dairy farms in several rural areas in Brazil, leading to high economic and social impact. Some phylogenetic studies have demonstrated the existence of two different populations of Brazilian Vaccinia virus strains circulating in nature, but little is known about their biological characteristics. Therefore, our goal was to study the virulence pattern of seven Brazilian Vaccinia virus strains. Infected BALB/c mice were monitored for morbidity, mortality and viral replication in organs as trachea, lungs, heart, kidneys, liver, brain and spleen. Based on the virulence potential, the Brazilian Vaccinia virus strains were grouped into two groups. One group contained GP1V, VBH, SAV and BAV which caused disease and death in infected mice and the second one included ARAV, GP2V and PSTV which did not cause any clinical signals or death in infected BALB/c mice. The subdivision of Brazilian Vaccinia virus strains into two groups is in agreement with previous genetic studies. Those data reinforce the existence of different populations circulating in Brazil regarding the genetic and virulence characteristics

Violência obstétrica: caracterização dos impactos ocasionados na vida das puérperas

Introdução: A violência obstétrica é considerada uma problemática grave de saúde pública que é silenciosa e mascarada, sendo capaz de cometer estragos consideráveis na vida das gestantes e dos seus familiares. A mesma quebra a esfera singular do parto, sem que haja respeito pela fisiologia da mulher ocasionando traumas consideráveis. Objetivo: Reconhecer os impactos ocasionados pela violência obstétrica na vida das puérperas, externalizando quais fatores contribuem para as intervenções desnecessárias. Método: Revisão bibliográfica da literatura realizada em dezembro de 2022 nas bases de dados BVS, LILACS, BDENF E MEDLINE através dos seguintes DeCS: "Episiotomia", "Saúde da mulher" e “Saúde Pública” combinados entre si pelo operador booleano AND. Foram encontrados 21 estudos e após aplicar os critérios de inclusão e exclusão, foram selecionados 8 estudos para compor a revisão. Utilizou-se como pergunta norteadora: “Quais os impactos transcendentes da violência obstétrica na vida das parturientes?”. Resultados: A mulher não é vista como protagonista do processo, há uma relação de submissão, que abre espaço para infantilização, fragilização, descaracterização e o advento da própria violência. Emprega-se um estigma em relação ao parto normal com discursos de que o mesmo é degradante ou de que a mulher não tem capacidade de ter o bebê por esse método, quando a literatura científica demonstra claramente os impactos positivos que o parto normal garante para o binômio. Conclusão: A violência obstetríca causa impactos significativos na vida das puérperas, visto que proporciona uma distorção do plano de parto anteriormente instituído, ocasionando sequelas psicológicas, sociais e emocionais

Transtorno Bipolar em crianças: análise de revisões sistemáticas entre 2019- 2023

O transtorno bipolar em crianças apresenta desafios diagnósticos, sendo crucial considerar fatores genéticos, sintomas inespecíficos e a sobreposição com outras condições psiquiátricas. O diagnóstico precoce e a avaliação neuropsicológica são essenciais para um tratamento adequado, considerando o impacto nas funções executivas e, por conseguinte, no desenvolvimento global da criança. Este estudo teve como objetivo revisar estudos publicados entre 2019 e 2023 sobre transtorno bipolar em crianças para entender descobertas, lacunas e orientações futuras. Nesse sentido, foi desenvolvida uma revisão sistemática de literatura a partir das bases de dados Literatura Latino-Americana e do Caribe em Ciências da Saúde (LILACS), o Medical Literature Analysis and Retrieval System Online (MEDLINE) e a Scientific Electronic Library Online (SCIELO). Com a análise e interpretação qualitativa dos resultados, concluiu-se que o estudo abordando o transtorno bipolar em crianças entre 2019 e 2023 evidencia desafios na identificação e tratamento, com destaque para a falta de critérios diagnósticos claros e lacunas no tratamento farmacológico, especialmente em relação ao uso do lítio. A pesquisa também ressalta a complexidade multifatorial do transtorno, envolvendo fatores genéticos, biológicos e ambientais, indicando a necessidade urgente de avanços na compreensão e manejo dessa condição na infância